31st Annual Community Advocacy Awards

Nomination Form

These awards recognize those in our community who consistently share and utilize their skills and talents above and beyond daily expectations to positively impact the lives of others. Please submit all nominations by 10/31/21.

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* 1. Please select the award for which you are nominating:

Bill Houlihan Professional Award: Recognizes a professional who advocates for children through their work, going over and beyond the daily expectations to improve the lives of children.

Christine Zak-Edmonds Volunteer Award: Recognizes those adults who embrace children and their issues, offer their time and talents as a volunteer to improve the lives of children.

Joey Stowell Youth Award: Recognizes a person, 18 years or younger, whose unique accomplishments have improved the quality of life for children and/or teens in central Illinois.

OSF HealthCare Children's Hospital of Illinois Community Advisory Board Group Award: Recognizes a company or organization that works continually over time in a variety of ways to improve the lives of children.

Dr. Mary Schultz Physician Award: Recognizes a physician who has spent his or her career improving the lives of children by providing outstanding medical care.

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* 2. Nominee Information:

Name:

Address:

City, State, Zip:

Phone Number:

Email:

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* 3. Nominator Information:

Name:

Address:

City, State, Zip:

Phone Number:

Email:

31st Annual Community Advocacy Awards

Nomination Form

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* 1. Please select the award for which you are nominating:

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* 2. Nominee Information:

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* 3. Nominator Information:

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* 4. Please type a summary of the nominee's work with children:

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* 5. How many years has the nominee been involved in this endeavor and what has the level of involvement been:

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* 6. Please provide additional details on accomplishments, honors or distinctions:

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* 7. Provide details on an estimated number of children impacted annually:

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* 8. Please provide additional details on the uniqueness of this endeavor:

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* 9. Please provide any additional comments or details that you believe makes this nominee deserving of this recognition: