Nomination Form

Nominee Information

Nominee Name:
Contact Name:
(if Nominee is a company)
Contact Title:
Nominee Address:
Zip Code:
Nominee Phone:
Nominee E-mail:
Website Url:

Nominator Information

Nominator Name:
Name of CEO:

(If nominator is a business, please complete this field.)
Nominator Title:
Nominator Phone:
Nominator E-mail:
Nominator Address:
Zip Code:
Primary Contact Name:
(if different from Nominator)
Primary Contact Phone:
(if different from Nominator)
Primary Contact E-mail:
(if different from Nominator)

Your Nominee must meet the following criteria: All are required.

Nominee resides in or impacts an agency in Lake, Orange, Osceola, Seminole or Volusia County

Nominated organization is a 501(c)(3) nonprofit organization registered in the five county area (applicable to AFP non-profit organization nominees)

Nominee has not previously received an award in the same category within past five years (please see History of Award Winners.)

Your nomination must include a narrative summary up to 750 words.

Uploadable document file extensions are limited to: pdf, doc, docx, rtf

Click on the field to add a narrative document. Required!

Nomination submitted electronically by Friday, August 28, 2020, 11:59pm

Type your name below. This is your electronic signature.


By clicking the Submit Form button below, you are agreeing
that all information provided is accurate and complete.