GCFV 2022 Family Violence Task Force Member of the Year Nomination Form
The Georgia Family Violence Task Force Member of the Year Award recognizes an individual whose work to end domestic violence in his/her community is truly outstanding. The Task Force Member of the Year consistently rises above the call of duty, and goes beyond what is expected in their work for survivor autonomy and safety as part of a coordinated community response.

The Task Force Member of the Year is a role model for others in their leadership, commitment, and dedication to ending domestic violence.

We recognize that this past year has been unprecedented, and many Task Forces and their members had to swiftly transition to new ways of working together, or consider suspending meetings altogether. Our internal review team will take this into account when reviewing nominations, so in your submissions please feel free to include challenges, obstacles, pivots, and transitions, as well as examples of leadership wins and successes.

To nominate a Task Force member for this award, please submit this form by August 1, 2022. The awardee will be notified by September 1, 2022.

The awardee is selected, based on the strength of the nomination. We look forward to reviewing your submissions!

If you have any questions, please contact stacey.seldon@dcs.ga.gov.
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Email *
Nominee's Name for Task Force Member of the Year: *
Nominee's Email Address and Phone Number *
Nominee's Job Title and Position on Task Force *
Nominee's Task Force: *
How long has the nominee for Task Force Member of the Year been active in the Task Force? *
Please discuss the ways in which the nominee has contributed to the Task Force: *
Explain why the nominee should be Task Force Member of the Year. Please list ways in which the nominee has demonstrated leadership and/or dedication to the Task Force: *
Your Name: *
Your Job Title *
Your position and/or affiliation with the Task Force: *
Your Phone Number *
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