Please complete this form to nominate an agency VOLUNTEER for a 2023 Community Action Award. Volunteer nominees may be individuals, couples and families, groups, or organizations, however, in the case of a group award, only one $100 gift card will be given to the selected nominee.*
 
Please complete and submit your nomination form by March 24, 2023. The awards will be distributed at our Michigan Community Action Legislative Day at the State Capitol in the new Heritage Hall in downtown Lansing on May 11, 2023 for Community Action Month. All nominees who are selected by the awards task force will be called forward to receive awards.
 
*In the case of a collective award, as for an organization, MCA can provide certificates for individual members of the organization, but only one gift card will be awarded.

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* 1. Name of Nominee

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* 2. City/Township of Nominee's Residence

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* 3. Has this nomination been approved by your CAA's Executive Director?  (Nominations must be approved by the ED)

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* 4. Nominated by:

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* 5. Email

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* 6. Phone

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* 7. Agency Name

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* 8. Please describe the VOLUNTEER'S contributions. (How did this volunteer impact your agency or your clients? Also specific information re volunteer hours, programs, etc.)

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* 9. Additional information you would like to share about the VOLUNTEER.

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