2013 MLK Peace Breakfast Award Nomination Form

Award Nomination Form

2013 MLK Peace Breakfast
Tell us about yourself
Full Name*

First NameLast Name
Organization
Phone Number*

Area CodePhone Number
E-mail*
Tell us about the nominee
Full Name*

First NameLast Name
Award Type*

StudentFaculty/StaffCommunity Member
Community Organization(s)*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Nominee Contribution Description

In as many words as necessary, please describe the nominee's commitment to promoting peace, justice, and compassion for all people through community involvement. Please address each of the following Nomination Guidelines in your description:

• Community Activism: In what ways is the individual involved with the community? How do these actions promote peace, justice and compassion for all people?

• Advocacy: For whom is the individual advocating through his/her community involvement? How wide is this individual's scope?

• Depth of Involvement: How long has the individual been committed to his/her cause(s)? To what extent is the individual involved with the cause(s)? In what ways is the individual's dedication to the cause(s) evident?

Please note: If the nominee is selected for the award, this description will be used for presentation of the award, publication in convention materials and/or for press release.
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