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* 1. Nominator Name (your name)

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* 2. Nominator Organization

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* 3. Nominator Email Address

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* 4. Nominator Phone Number

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* 5. Name of Nominee

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* 6. Nominee Organization 

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* 7. Nominee Title

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* 8. Nominee Email address

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* 9. Nominee Phone Number

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* 10. Please list which organization the nominee is associated with. 

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* 11. In 1000 words or less, please describe why the nominee should receive a 2024 Response to Recovery Hero Award. Please describe ways the nominee has gone above in beyond to protect and/or provide services to children in Connecticut.

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* 12. If possible, please attach a resume or CV for the person you are nominating.

0 of 12 answered
 

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