YMCA Legacy Award Nomination 2022 YMCA Professional Network | Chapter 41 Question Title * 1. YMCA Association Question Title * 2. Staff name filling out this form: Question Title * 3. Does the CEO know of and approve this nominee? Yes No Question Title * 4. CEO email Question Title * 5. First name of nominee Question Title * 6. Last name of nominee Question Title * 7. Department or Job Title of Nominee (when in their role) Question Title * 8. Approximate years of employment in the Y movement For questions 5-11, you may instead upload a document at the bottom of this form that should clearly address the criteria of contributions, accomplishments, and innovation. Question Title * 9. CONTRIBUTIONS: Describe how this individual contributed to their field in one or more of the following manners: Has made a significant contribution to the development of their field that benefited a local YMCA and/or overall YMCA movement. Demonstrated the highest standards of leadership in the YMCA movement Is respected and recognized as a role model to peers in their field Question Title * 10. ACCOMPLISHMENTS: Share any accomplishments the individual has achieved over the course of at least 10 years: Question Title * 11. INNOVATION: List any programs, processes, or projects that this individual has designed or implemented that have been replicated within their association or other YMCAs. Question Title * 12. Please share any further information you feel relevant for the YPN Board to consider. Question Title * 13. Optional: Upload a file in lieu of answering questions 5-11 in the boxes above. PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Optional: Upload a file in lieu of answering questions 5-11 in the boxes above. Done - Thank you!