Ryan Sutton/Martin Lovelace-Chandler Self Advocate Award

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

People with disabilities have the right to be and be supported as self-advocates who determine decisions made in all areas of their daily lives and policies that impact them. Please nominate someone you believe should be honored for their ability to advocate for themselves and the disability community as a whole.

Your Name *

Your Email *

Your Phone Number *

Nominee Name *

Nominee Email *

Nominee Phone Number *

How do you know this nominee? *

Please share 1-2 brief stories that exemplify how this nominee is an impactful self advocate. (Try to share lessons that you’ve learned about the importance of inclusion and access from this nominee.) *

From your observation, please describe ways that this nominee’s self advocacy positively impacts people with disabilities. *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Arkansas Support Network. Report Abuse

Forms