2014 PAR Awards - Nominations Form

1. Nominations Form

PAR is seeking award nominations in six categories for the 2014 Awards Celebration and Awards Ceremony.

• PAR Humanitarian
• PAR Advocate of the Year
• Direct Support Professional of the Year
• Community Employer of the Year
• PAR “Everyday Images” Award

Who do you know in your community or in Pennsylvania that deserves recognition for their work with individuals with autism and intellectual disabilities? Tell us!

Nominations can be submitted online or by faxing (717.236.5625), emailing (par@par.net) or mailing this form to:

4 Lemoyne Drive, Suite 203
Lemoyne, PA 17043

All nominations are due no later than Monday, September 8, 2014.

Winners will be notified the first week of October and honored at PAR’s 44th Annual Meeting and Awards Celebration, which takes place Thursday, November 13th at the Harrisburg Hilton as part of the PAR Solutions Conference.

Question Title

* 1. Nomination Category (Choose one. A separate form is necessary for each nomination. See PAR Mail _____ for descriptions of each award.)

PAR Humanitarian

PAR Advocate of the Year

PAR Direct Support Professional of the Year

PAR Employer of the Year

PAR Everyday Images Award

Question Title

* 2. Nominated Individual, Organization or Group

Name:

Company:

Address:

Address 2:

City/Town:

State:

ZIP/Postal Code:

Email Address:

Phone Number:

Question Title

* 3. Nomination submitted by:

Name:

Company:

Address:

Address 2:

City/Town:

State:

ZIP/Postal Code:

Email Address:

Phone Number:

Question Title

* 4. Please explain why you believe the nominee deserves to be honored in this category. Include a summary of the nominee’s accomplishments.

Question Title

* 5. Are you submitting an image for the PAR Everyday Images Award?

Yes