Rose Award Nomination Form

The final day to submit nominations is February 14th, 2023.

Nominee's Name(Required)

First Last

Nominee's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nominee's Phone(Required)

Nominee's Email(Required)

Nominee’s Activities and Accomplishments

Describe the Nominee’s notable activities and accomplishments— personal, professional, or otherwise

Nominee’s Impact on the Community

Describe how the Nominee is/has been instrumental in initiating or leading efforts to benefit our community

Why should this Nominee receive the Christian Women’s Job Corps Rose Award?

Any other information you would include about your Nominee:

Your Name(Required)

First Last

Your Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Email(Required)

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Name

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