2010 Nomination Form

Award Category:

Be There For Your Kids Father of the Year

Program, Coalition or Agency of the Year

Policymaker or Advocate of the Year

County Child Welfare Department

Colorado Fatherhood Council Member of the Year

Outstanding Individual

Child Welfare Caseworker of the Year

Other:

Please respond to the following questions. (Please be concise; limit your responses to 250 words per question).

Describe the overall efforts of the nominee. Who do they serve and in what ways do they serve them?

Describe the impact and demonstrated results of the nominee's efforts (on fathers, the community, their children, the organization, etc).

How has the nominee provided leadership for fathers, their children and/or the community? How has their effort galvanized fathers and/or the community to address these issues constructively? How has the nominee been effective in shaping programs or policies that have a positive impact on these issues? How has the father demonstrated excellence in fathering, provision of community leadership, service as a public role model or mentorship?

What is your relationship with this nominee? How have you come to be familiar with his/her accomplishments? Also, please add any pertinent information you would like to share. If you are nominating a member of your family (i.e. parent, child, spouse, etc.), please identify a second nominator (not a family member) who will support the nomination.