*Required field

• Name:*
• Address:*
• Phone:*
• Email:*

• Nominee's Name:*
• Nominee's Address:*
• Nominee's Phone:
• Nominee's Email: (if known)

• Standards

  To be eligible for the award:

  1. Nominee has provided services to Elk Grove residents with disabilities within the last 12 months.
  2. Nominee has not won the award in the last two years.
  3. Nominee does not provide services, for which they’re being nominated, through an organization that has won the award in the last two years.
  4. Nominee provides services that are free from discrimination.

  Nomination Statement

  Please describe why and how the organization or individual goes "Above and Beyond" to improve the quality of life for individuals with disabilities in Elk Grove within the last 12 months. Please be as specific as possible. References and supporting material are not required, but are allowed.

  In writing your nomination statement, answers to the following questions are required:

  1. What are the services the nominee provides?
  2. Why are the services needed?
  3. What benefit and impact is there on the individuals and or communities receiving the services.
  4. How often are the services provided and how long do they last?
  5. Approximately how many Elk Grove residents received these services?
  6. Does the nominee collaborate with other services providers?
  7. Is the organization or person paid for the services they provide?
     1. If paid, please explain how they go above and beyond someone else in their same position.
     2. If unpaid, please explain how they go above and beyond.