Peter Armstrong Community of Excellence Award

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* 1. I would like to nominate

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* 2. Please provide the contact details for the nominee:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Your Contact Details:

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 4. Please tell us about the nominee's efforts to serve the addiction community beyond the call of duty.

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* 5. Please describe the impact of your nominee on a local, regional level.

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* 6. How has the nominee impacted the recovery community, in particular Renascent?

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* 7. Is there anything else you would like the committee to consider about your nominee?

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* 8. Describe your nominee in two words:

First word that comes to mind when describing your nominee

Second word that comes to mind when describing your nominee