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2026 Dr. John Kowalczyk Outstanding Citizenship Award

Dr. John Kowalczyk Outstanding Citizenship Award Nomination Form


NOMINATION DEADLINE: Friday, June 5, 2026


About the Award: This award is designed to highlight and celebrate individuals supported by their local Arc New York Chapter by recognizing their achievements and contributions made to their local Chapter, community and/or peers. Nominees and recipients are individuals who not only use services provided by their local Chapter of The Arc New York but also help to provide support to others in a manner that benefits other people with intellectual or developmental disabilities and their community. One (1) award in the amount of $500, along with a commemorative personalized glass award is presented annually.

Eligibility Criteria:
  • The nominee must have an intellectual or developmental disability
  • The nominee must be receiving services/support from a Chapter of The Arc New York
  • One nomination may be submitted for each County within a Chapter
  • The nominee should be an individual who is recognized to be someone that exemplifies one or more of the following traits: peer advocacy, a community supporter, someone who participates in organizing and/or supporting events at the Chapter level, or an overall positive support for others in their community circle


Application Requirements:
  • Completed application
  • One (1) peer letter of support must be included. Up to two (2) additional letters from others may be included if desired. Letters submitted should be current and specific to this nomination.

The Arc New York Dr. John Kowalczyk Outstanding Citizenship Award will be presented in person at the September Annual Meeting.
1.Nominee Information(Required.)
2.How has the nominee directly or indirectly helped to enable others with IDD achieve their own personal outcomes (goals/growth)?(Required.)
3.What groups or Chapter/community activities is the nominee currently involved in?(Required.)
4.How has the nominee helped to support others through active participation of events and interactions? (Specific actions and characteristics or approach)(Required.)
5.Explain the nominee’s level of involvement in providing support to their peers, Chapter events, and/or community events.(Required.)
6.What challenges within your Chapter and/or community has the nominee recognized and taken steps towards improving or establishing support?(Required.)
7.Contact information for person making this nomination:
The person making this nomination should be of an Executive/management, Board or PR position(Required.)
8.Digital Signature of person making this nomination - Please type your full name and the date into the field below as your electronic signature (ex. Jane Doe, 5/25/26)(Required.)
9.Upload Letter of Recommendation 1
No file chosen
10.Upload Letter of Recommendation 2
No file chosen
Please email any additional documentation or questions to:

Christina Canino
Senior Project Coordinator
The Arc New York State Office
Email: Christina.Canino@TheArcNY.org