Thomas J. Blazusiak Memorial Award Nomination Form

The Public Human Services Attorneys (PHSA) recognize someone who has contributed to the objectives of PHSA through significant contributions in the area of public welfare law or policy. The Thomas J. Blazusiak Memorial Award is presented to a person who is active in developing and/or supporting improved legislation and public policy pertaining to the administration of public welfare, supports inclusiveness and innovation in the discussion and exchange of information in the area of public welfare law, demonstrates strong leadership qualities within their field of work, and serves as a role model and mentor for others. The recipient of this award is a person of integrity, courage, and compassion.


Criteria:

  • Currently is or has been active in developing and/or supporting improved legal and policy practice pertaining to the administration of public welfare
  • Supports inclusiveness and innovation in the discussion and exchange of information in the area of public welfare law
  • Exhibits a high degree of professionalism and competence in their field of work
  • Demonstrates strong leadership qualities within their field of work
  • Person of integrity, courage, good humor, and compassion
  • Cordial in interactions with others
  • Serves as a role model and mentor for others


Deadline for nominations is Friday, June 30, 2023. If you have any questions, please contact Marie Comito at mcomito@aphsa.org.

Nominee Information

Tell us about your nominee.

Who are you nominating?

Please provide the full, accurate title of the nominee.

Please spell out the nominee's full agency name.

Does this individual know they are being nominated for this award?*

This section allows you to provide additional documentation (up to 30 MB per file) to support your nomination.

Drag and drop files here or

Nominator Information

Who is making the nomination?

Please spell out full agency name.

Phone