2015Awards Nomination Form

Legacy of Women Award Nominees make significant contributions to one of the following fields: Arts, Business, Education, Health & Human Services, & Volunteerism. All nominees will be judged on the following criteria: commitment, achievements, initiative, impact, and additional contributions.

Must be typed: (This form may be recreated or downloaded at MS Word)

Nominee’s Name: / Business/Organization:
Title/Position / Email:
Home Address: / Home Phone:
City, State, Zip: / Business Phone:
Business Address: / Fax:
City, State, Zip: / Nomination Field:
Nominator’s Name: / Business/Organization:
Address: / Phone:
City, State, Zip: / Fax:
Email:
Affiliation with the Honoree:

Please answer the following questions on 8 ½ x 11 paper; observe word limits; place nominee’s name on each response sheet; label each response with the number of the question being answered. It is not necessary to use a separate sheet of paper for each response.

  1. How long, and in what capacity, has the nominee been involved in the field in which she is nominated? (100 word Max)
  2. What are significant contributions that she has made to her field? (300 word maximum.)
  3. How has the nominee used innovation and creativity to excel in her field? (250 word maximum.)
  4. How have her contributions impacted her field and the community at large? (150 word maximum.)
  5. What other personal and/or professional accomplishments or extraordinary attributes about the nominee would you like to share with the judges? (100 word maximum.)

Eligibility Requirements:

  • Nominee must live and/or work in TarrantCounty.
  • Two (only 2) letters of support for the nominee must be included with the application. The two (2) letters of recommendations are in addition to your answers to the five (5) questions above.
  • Resumes/biosmay be submitted as additional supporting material. Please understand that a resume will not be substituted for an application. Resumes/bios will be the only additional supporting material considered.
  • Only complete nominations will be accepted; packet must include complete application along with two letters of support when mailed or delivered.
  • Previous nominees are eligible – Please submit a new updated application.

Please return nomination form byFriday, May 15thto:Valerie Salter

Legacy of Women Awards

SafeHaven of Tarrant County

8701 W. Bedford Euless Rd., Suite 600

Hurst, Texas 76053

E-mail:

Phone: 817-535-6462 ext. 106

Fax: 817-510-0239

Benefitting SafeHaven of Tarrant County. For more information click .