MNADV 2022 ANNUAL AWARDS NOMINATION FORM
On Thursday, October 27th from 4:00 – 5:00 pm (EST), during our 2022 Virtual Annual Meeting, the Maryland Network Against Domestic Violence will recognize individuals and groups who have made a significant contribution toward the elimination of domestic violence in Maryland. 

We are honored to recognize those who have been working effectively and collaboratively within the domestic violence community to positively impact victims and survivors. 

All entries must be received by Friday, October 14th at 5:00 pm (EST).

Note: MNADV Staff, Award Selection Committee Members and self nominations are ineligible for consideration.

Please provide complete and accurate information that is as detailed and specific as possible. One awardee will be selected from the nominations. If you have any questions about this form or the nomination process, please contact Renee Wells, Operations Manager, at rwells@mnadv.org or call 301-852-3976  
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Email *
Name of Nominee (Person being nominated): *
Organization/Company (If applicable): *
City/Town: *
Nominees Email Address: *
Nominees Phone Number: *
Award Categories
COMMUNITY PARTNERS AWARD: Selected nominee(s) will have a demonstrated track record as a community member that has provided exceptional support to the domestic violence community and/or to victims/survivors themselves. This may include people within health care, education, law enforcement, criminal justice, social services, faith-based organizations, the local business community, media, or other related fields. 

DOMESTIC VIOLENCE ADVOCATE AWARD: Selected nominee will have a demonstrated track record as a staff member or volunteer at an organization that provides direct services to victims/survivors who goes above and beyond the job description to make a difference. * ONLY Domestic Violence Service Provider programs are eligible to submit for this nomination. * Programs are encouraged to nominate ONE (1) person - a staff member, volunteer, or board member. * ONE Domestic Violence Service Provider Awardee will be selected from the nominations, other nominees will be recognized at the Annual Celebration as a Program Honoree. * Criteria that will be considered in the review process include an exceptional, special, noteworthy, and/or innovative contribution to eliminating domestic violence that goes above and beyond a person's regular roles and responsibilities. 

LEADERSHIP AWARD: Selected nominee will have a demonstrated track record and successes in leading statewide, regional, or community-based systems advocacy efforts that aim to improve the response to domestic violence and that works toward the elimination of domestic violence. 

OUTSTANDING ACHIEVEMENT AWARD: This award recognizes a person’s dedication to ending domestic violence. A demonstrated track record of outstanding achievement in advocacy, organizing, and tireless service has allowed this person to plant the seeds of significant change in the lives of survivors, as well as change the landscape of domestic violence related systems in Maryland. The recipient will be selected based on the following criteria: * experienced in survivor-centered advocacy for victims/survivors and their children; * level of involvement in domestic violence advocacy; * vision of resolving both the micro and macro level issues faced by victims in Maryland; * leadership demonstrating a vision of ending gender-based violence; * and Commitment to social justice. 

For which award category is this person being nominated? 
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Name of person who nominating the individual for the award: *
Program/Organization/Agency of nominator: *
Title/Position of nominator: *
City/Town of nominator: *
Email Address of nominator: *
Phone Number of nominator: *
Nomination Summary:

 Why are you nominating this person for an award? 

What is it about their accomplishments, personality, work ethic, track record, etc. that makes this person an exemplary nominee?
 
In what ways does this person work as an active participant in the domestic violence community? 

How and with whom do they collaborate within the community? 

Feel free to give examples, successes, or anecdotes that demonstrate how this person meets the criteria for the award category that you selected above. (6-8 sentences)  
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Nominee Short Biography/Summary of Relevant Work:

Please provide a short biographical description of the person's background  Please provide a short biographical description of the person you are nominating which may include their education, profession, work history, or other information that is relevant to the nomination. (2-5 sentences)  
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