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NASW-LA 2025 Region Awards Nomination Form

IMPORTANT REMINDERS:

1. Nominations must be submitted by an active NASW member
2. Submit all documents in the PDF format (excluding photos)
3. Title documents in the following format, "Nominee's last name + document type" (ex: Smith Resume, Smith Summary, etc.)

**Submission deadline is October 19, 2025.

Read more about Award Categories and Guidelines here.
1.Please select your Region:(Required.)
2.Name of Nominee:(Required.)
3.Nominated for:(Required.)
4.Nominee Place of Employment:(Required.)
5.Nominee Job Title:(Required.)
6.Nominee Mailing Address (Street, City, Zip Code):(Required.)
7.Nominee email address:(Required.)
8.Nominee Phone Number:(Required.)
9.Has this person received an official reprimand by NASW Louisiana in the last 5 years?(Required.)
10.Has this person had action taken against their license by the LASBSWE in the last 5 years?(Required.)
MEDIA/PUBLIC OFFICIAL/PUBLIC CITIZEN NOMINATIONS
Nominees for Media, Public Elected Official and Public Citizen Awards must receive the NASW Code of Ethics Preamble.
11.Did this nominee receive the NASW Code of Ethics Preamble?
NOMINATED BY
12.Name of Member Submitting Nomination:(Required.)
13.Mailing Address (Street, City, Zip Code)(Required.)
14.Email Address:(Required.)
SUPPORTING MATERIALS

Summary of Contributions. Please note that the Summary of Contributions is distinct from a letter of recommendation. The Summary of Contributions should describe how the nominee has met the criteria for that award as defined in the Social Work Awards Criteria. You may type the summary below or attach it as a document. If you attach the document please type "attached" in the text field.

Letters of Recommendation. Three letters of recommendation are required for each nomination. ALL letters of recommendation should include contact information for the person writing the letter (ie. phone AND email address).

Photo. Please submit a digital headshot of the nominee for use in the award recipient announcement campaign, should they win a Chapter Award.
15.Summary of Contibutions(Required.)
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16.1st Letter of Recommendation:(Required.)
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17.2nd Letter of Recommendation:(Required.)
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18.3rd Letter of Recommendation:(Required.)
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19.Curriculum Vita/Resume:(Required.)
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20.Picture of Nominee:(Required.)
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21.Career Goals Essay (Outstanding BSW/MSW Student of the Year ONLY)
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22.A statement from the candidate’s school addressing what makes the student outstanding (Outstanding BSW/MSW Student of the Year ONLY)
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