Better Hearing and Speech Award Nomination Form
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Email *
Better Hearing and Speech Award Criteria
1. The Nebraska Speech Language and Hearing Association (NSLHA) will select up to three (3) Better Hearing and Speech Month Award recipients. The award recipient will be recognized during a Better Hearing and Speech Month proclamation ceremony at the State Capitol in Lincoln, Nebraska in May.
2. There are no age restrictions for the Representative nominees.
3. Nominees must have a significant hearing, speech and/or language challenge.
4. Nominees may be sponsored by parents, spouses, teachers or NSLHA members.
5. Entry forms must provide a professional estimate of the degree of hearing, language and/or speech impairments.
6. The Child Representative and/or Adult Representative will be used in photographs to promote Better Hearing and Speech Month in Nebraska during the month of May.  
7. All entries become the property of NSLHA, and all decisions are final.
Nominee's Name *
Parent/Guardian Name if Nominee is a Child
Parent/Guardian's Address
Parent/Guardian's Phone
Parent/Guardian's Email
Name of Sponsoring Organization or Individual *
Phone Number for Sponsoring Organization or Individual *
Email for Sponsoring Organization or Individual *
Professional estimation of nominee’s speech, language and/or hearing challenges *
Brief description of nominee’s communication skills *
Describe how the nominee has addressed speech, language and/or hearing challenges *
Explain why the nominee should be selected as a Better Hearing Speech Award recipient
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