2023 80% in Every Community National Achievement Award Submission Form

The National Colorectal Cancer Roundtable (NCCRT) is seeking submissions for the 2023 80% in Every Community National Achievement Awards, a competitive recognition program that seeks to highlight success stories in the effort to reach colorectal cancer screening rates of 80% and higher across the nation.

Please note:

Complete submission forms must be submitted by Thursday, December 1st, 2022 at 8 PM ET.
Self-nominations and multiple entries are accepted.
Submissions that exceed the word limits will not be considered.
Once you begin entering your submission it is not possible to save a draft. We recommend using word-processing software (for example, Word) to draft your submission, then copy and paste into the fields below.
Visit the awards webpage to learn more about eligibility, rules, selection criteria and recognition.
Please email nccrt@cancer.org with any questions.

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* 1. Contact Information for the Person Submitting the Nomination

First Name *

Last Name *

Organization (if applicable)

City/Town *

State/Province *

Phone *

Email Address *

Website

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* 2. Are you nominating your own program or work? If yes, please skip to Question 4. If no, please provide contact information for the nominee below.

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* 3. Contact Information for the Nominee (please leave blank if you are self-nominating)

First Name

Last Name

Organization (if applicable)

City/Town

State/Province

Phone

Email Address

Website

Twitter Handle

2023 80% in Every Community National Achievement Award Submission Form

Question Title

* 1. Contact Information for the Person Submitting the Nomination

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* 2. Are you nominating your own program or work? If yes, please skip to Question 4. If no, please provide contact information for the nominee below.

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* 3. Contact Information for the Nominee (please leave blank if you are self-nominating)

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* 4. Please select your Submission Category.

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* 5. Please describe your project goal or individual mission. (max 50 words)

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* 6. Please provide an overview of the activity, initiative or outreach effort, including target audience. (max 400 words)

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* 7. Please provide the reason the individual/program entity should be recognized, including evidence of impact. (max 150 words)