What Area or Geography are you in the Region you selected? (ie: British Columbia, Queensland, or Southeast Area)
Your answer
Is this the Official selection of the Region / Center / Area?
If this is NOT an Official Selection, DO NOT submit this form. Please contact your Region or Area Council to make your nomination to the Ron Hering Nominating council.
Clear selection
II. Your Information
Who is submitting the Award Information?
Your Name (First Last) *
Your answer
Your Email Address *
Your answer
Your Role in the Community *
Your answer
III. Award Recipient Information
Recipient Name (First)(Last) *
Your answer
Recipient Inner Resource / Animal Name *
Your answer
Recipient Email Address *
Your answer
Recipient Mission Statement *
Your answer
Recipient Action in the World & Bio Statement *
Your answer
Recipient Web Site (if applicable)
Your answer
Award Mailing Information
Where should we send the award plaque .pdf when it is ready?
Award Mailing Address Name *
Your answer
Award Mailing Address *
In the USA, please provide a full mailing address. In other Global Regions - please provide the email address where we should send the PDF version of the award for in-country production.
Your answer
Do you have a photograph of the recipient(s)? *
How to Send Your Photograph:
PLEASE EMAIL Your Photograph of the recipient with the NAME of the RECIPIENT as the SUBJECT LINE and the FILE NAME matching the name of the recipient. Please select the highest quality photo you can. Send to communications@mkpusa.org
Does the ManKind Project have permission to display and promote the picture and work of the Recipient? *
Submit
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