DBS “Successful 75” Client Recognition Nomination Form


The Division of Blind Services (DBS) is seeking nominations for the "Successful 75 Awards". Please use this form to nominate a Current or Former DBS Client for the “Successful 75” award. The nominee must demonstrate a high level of leadership, perseverance, independence and determination to be successful.

The nomination form should only take about 10 minutes to complete. Use the 'Next' and 'Prev' buttons at the bottom of each page to navigate. Click 'Submit' at the end to finish the questionnaire and close your browser. Once you have submitted your nomination form, responses cannot be changed.