2017 MNADV Annual Awards Nomination Form: Leadership and Community Partners Awards

2017 Annual Award Nomination Form

Leadership and Community Partners Awards

During our 2017 Annual Meeting and Awards Dinner on Thursday, October 26, 2017, at the DoubleTree by Hilton Annapolis, the Maryland Network Against Domestic Violence will recognize individuals who have made a significant contribution toward the elimination of domestic violence. All entries must be received by August 18, 2017.

Criteria and Selection Process: Person(s) who have previously received an MNADV award are not eligible for nomination. For a list of past MNADV Awardees, click here. Awardees who are chosen are selected for their exceptional efforts in working towards the elimination of domestic violence in Maryland by working effectively and collaboratively within the domestic violence community to positively impact victims and survivors. Awardees will be chosen by the Nomination Review Committee, which is composed of members of the MNADV Board of Directors and the Executive Director. Criteria that will be considered in the review process include: demonstrated collaboration with key stakeholders in your community (MNADV, local domestic violence programs, etc.) and an exceptional, special, noteworthy, and/or innovative contribution to eliminating domestic violence that goes above and beyond a person's regular roles and responsibilities.

Question Title

* 1. Please enter the information for the person you are nominating (Note: The person you are nominating must be someone other than yourself. A public relations firm cannot nominate a person or organization who is their client. MNADV staff members and board members are not eligible to receive an award. A person may not have previously received a MNADV award):

Name of Nominee: *

Company/Organization/Agency (if applicable):

Title:

Address: *

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number: *

Question Title

* 2. Who is nominating the person for the award (must be different from Question 1 above)?

Primary Contact for Nomination (Name): *

Program/Organization/Agency (if applicable):

Title:

Address: *

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number: *

Question Title

* 3. For which award category is this person being nominated?

LEADERSHIP AWARD: Selected nominee(s) will have a demonstrated track record and successes in leading statewide, regional, or community-based systems advocacy efforts that aim to improve the response to domestic violence and that works toward the elimination of domestic violence.

COMMUNITY PARTNERS AWARD: Selected nominee(s) will have a demonstrated track record as a staff member, volunteer, or community member that has provided exceptional support to the domestic violence community and/or to victims/survivors themselves. This may include people within health care, education, law enforcement, criminal justice, social services, faith-based organizations, the local business community, media, or other related fields.