Governor’s Committee on People with Disabilities
Barbara Jordan Media Awards
Entry Form
Self-nominations are encouraged
Deadline for submissions is February 17
Nominee Information:
STORY TITLE:
Person or Organization Nominated:
Person’s Employer or Media Outlet:
Street address:
City, State, Zip code:
Phone:
Email address:
Website address (if available):
Nominator Information(if other than nominee)
Name of Nominator:
Street address:
City, State, Zip code:
Phone:
Email address:
Award Category (select one):
Broadcast
Photojournalism
Internet
High School Student
College Student
Book
Please complete all information below:
Nominee’s Name:
Audience (Who are the primary viewers, readers or listeners - e.g., general public, children, and professionals?):
Distribution (local, statewide, national):
Running time or approximate word count:
Date story was first presented to the public:
Captioning provided? (if applicable):
NOTE: Broadcasters, please request the captioned version of the piece to use as your entry if possible.
STORY TITLE:
Brief description of entry:
Where did this work appear? (Include operational URL link if available)
Check at least two (2) of the following four (4) required entry criteria:
Produced in Texas
Produced by an organization with corporate headquarters in Texas
Used Texans with disabilities as the subject or in production of the materials
Broadcast, published or distributed in Texas
Include any applicable supporting material (i.e. brochures, press releases, etc, that refer to the submission). Include brief description of supporting material:
How did the piece advance issues of importance for Texans with disabilities? Consider topics such as access, communication, education, emergency management, health, housing, recreation, transportation, veterans or workforce, as well as overall public perception.
Deadline for submissions is February 17
Please be aware that all information that you submit to the Office of the Governor is subject to public disclosure under the Texas Public Information Act.
NOTE: By submitting an entry, you acknowledge that the submission is the nominee’s original work and does not violate copyright law, intellectual property rights, right of privacy, right of publicity or any other rights. The GCPD and its partners reserve the right to use the winning works for presentation and media purposes, and are allowed to reproduce it for promotion of the competition and its results.No materials will be used by GCPD for commercial purposes or for profit.
All materials should be sent to:
OR by postal mail to:
Barbara Jordan Media Awards
Texas Governor's Committee on People with Disabilities
P.O. Box 12428
Austin TX 78711
OR in person to:
1100 San Jacinto Blvd, Suite 1.200
Austin TX 78701
512.463.5740 - Phone
or Dial 711 for Relay Services
512.463.5745 - Fax