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The Colorado Health Foundation is soliciting nominations for the 2023 Dr. Virgilio Licona Community Health Leadership Award.

Nomination applications are open through Thursday, March 30, 2023. For more information about the nomination process, please contact David Proper, communication officer, at 303-953-3681 or dproper@coloradohealth.org.

Note: Please complete all application questions and provide specific examples for each that will help us understand how the nominee and their work align with the eligibility criteria.
Step 1: Nominator’s Details

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1. First Name

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2. Last Name

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3. Pronouns

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4. Organization

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5. Title

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6. Email Address

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7. Phone Number

Step 2: Enter Nominee's Details

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8. First Name

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9. Last Name

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10. Pronouns

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11. Organization

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12. Title

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13. Email Address

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14. Phone Number

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15. Submission Title (Nominee's name and organization)

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16. Please provide a short biography of the nominee (500 words or less).

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17. Who does the nominee serve through their work? Please provide specific demographic information (race, ethnicity, age, gender identity, etc.) about the people and communities they serve.

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18. How is the nominee addressing inequities and improving health outcomes for the communities they serve? Provide specific examples.

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19. How does the nominee engage with the communities that they serve? Provide specific examples.

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20. How has the nominee significantly influenced and/or contributed to systems- and community-level change? Please provide specific examples (such as activities related to advocacy/implementation of public policy or changes in on-the-ground practices).

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21. How has the nominee fostered lasting connections and bridged relationships among people with differing backgrounds or viewpoints to achieve positive health outcomes? Provide specific examples.

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22. Provide any useful links

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