Phoenix Society Advocacy Award
Nomination Form 2018
Recognized during Burn Awareness Week
February 4-10, 2018
To acknowledge an individual whose advocacy efforts have brought greater awareness to the burn community by actively providing information, education, and promoting positive change.
Please submit this completed form no later than December 15, 2017.
Nominee First Name
Nominee Last Name
Submitter Last Name
Submitter First Name
How does the nominee bring awareness to or about the burn community?
Has the nominee had to deal with any challenges when bringing awareness to the burn community?
Does the nominee use special or unique methods to bring awareness to the burn community?
Please include any additional information to support why the nominee should be considered for the award:
Send me a copy of my responses
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