Leadership Award Nomination Form
Nominee Address:
Your Address:
Nominee Phone Number:
Your Phone Number:
Your Relationship to the Nominee
What is your relationship to the nominee?
Award Selection
You can nominate the same person for multiple awards.
You will be required to complete two questions for each award.
Recipients will be announced at the Leadership Summit.
All nominations due by Oct. 1, 2008
Fran Delaney Challenge & Respect Award (See Description)
(Limit is 500 words)
Scroll down to the end of this form to submit your nomination or complete another question set to nominate this person for another award.
Mary Lou Krauseneck Courage & Love Award (See Description)
Courage & Love Award Question #2: In his/her community, how has this person attitude inspired others to remain positive when faced with a challenge such as ALS?
Stephen Heywood Patients Today Award (See Description)
Patients Today Award Question #2: How has this person educated others and spread awareness about ALS research?
Stephen Milne Adventurous Spirit Award (See Description)
Adventurous Spirit Award Question #1: How has this person found innovative ways to fundraise and aid ALS research?
Adventurous Spirit Award Question #2: Give two examples of the innovative fundraisers and advocacy efforts by this person.
Sunday, October 19th
Lab Tours & Open House
View Schedule
Monday, October 20th
Research Symposium
Registration
Travel Information & Local Accommodations
Past Summits
Leadership Awards
Sponsorship
Contact
ALS TDI
Vanessa Plant
617-441-7230
summit@als.net
