2023 Infertility Conference Lean on Me Award
At UIRC, one of our goals is to ensure that no one feels alone on their infertility journey, but we can't do that alone. Over the years, we have both seen & heard of individuals going the extra mile (or more!) to support someone they know experiencing infertility and we want to honor them. 
 
Lean On Me Award - This award acknowledges an individual who has consistently gone above and beyond to offer support for those going through infertility in our community. This could be a friend, a partner or spouse, a family member; anyone that has stepped up to support you and be there for you during these difficult times.

If you would like to nominate someone in your life, please complete our form below. All nominations must be received by August 19, 2023.  After completing a de-identification process, our team will then review all submissions and select a winner. The nominator and winner will be notified on September 4, 2023 via email.

Please note- both the nominator and the winner will receive complimentary tickets and are required to be present at the award presentation happening at our 8th Annual 2023 Infertility Conference on Saturday, September 23rd located in Sandy, Utah.
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Email *
What is your name? *
What is your email? *
What is your phone number? *
What is your connection to the infertility community? *
i.e. patient, supporter, specialist, counselor, etc.
Who are you nominating? (First and last name) *
What is their connection to the infertility community? *
i.e. fellow infertility warrior, partner or spouse, friend, family member, other
What is your nominee's email? *
What is your nominee's phone number? *
In one paragraph (300 word limit), explain why you believe your nominee deserves the Lean on Me award: *
I agree to the following terms:

* If selected, I and the award winner will be present for the award ceremony occurring on September 23, 2023 at the Gail Miller Conference Center at Miller Campus located in Sandy, Utah.

* If selected, our submission will be briefly shared as part of the award presentation.

* Photos of the award ceremony will be taken and shared on UIRC's website and social media platforms.

* All submissions will be de-identified and shared on UIRC's website and social media platforms.
*
Required
Thank you for your submission! 
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