Award Nomination Form - The Arc Pikes Peak Region

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Award Nomination FormThe Arc Pikes Peak Region2024-03-27T13:02:27-06:00

The Arc Pikes Peak Region

2024 Annual Awards Celebration Nomination Form

In-Person Celebration Fair on Friday, September 27th, 9am to 5pm, 2024 at 10 N. Meade Ave., Colorado Springs, CO 80909; Virtual Awards Ceremony to Follow

Thank you for your interest in nominating our community members for an award at The Arc Pikes Peak Region’s annual dinner. We take great pride in our ability to recognize the outstanding people and work done in our community. We ask that only complete forms be submitted, as the review committee may not be familiar with the nominee. We will only review original nomination forms, so please do not submit multiple copies of the same nomination form. Please use a separate form for each person/program being nominated. Click here to download a printable version of this form.

Forms may be emailed to morgan@thearcppr.org; mailed to The Arc Pikes Peak Region, attn: Annual Dinner & Awards Nomination; or faxed to 719-471-4828.

The nomination form is due Thursday, June 27th 2024 by 5 pm. Please submit forms early so we can get any questions answered prior to the review meeting.

If you are human, leave this field blank.

Nomination Form - The Arc Pikes Peak Region Annual Awards Celebration

The Arc Pikes Peak Region Annual Awards Celebration: Stepping into the Spotlight WHEN: Friday, September 27th 2024, 9am - 5pm WHERE: 10 N. Meade Ave, Colorado Springs, CO 80909

Nomination Category (Please check one) *

Achiever of the Year (individual with intellectual and/or developmental disabilities who has shown determination to succeed).

Public School Personnel (An employee or volunteer in a Pre-K through transition school. EX: teachers, para professionals, etc.)

Support Services (A person who provides administrative or indirect support. EX: administrative, benefits, bus driver, etc.)

Professional of the Year (Person providing professional supports or services in the community. EX:nurse, attorney, therapist, etc.)

Parent/Family Advocate (A family member or friend that advocated for the rights & welfare of a person with IDD).

Outstanding Program (A program that supports people with IDD in the community. EX: agencies, programs within agencies, etc.)

Residential Service Provider (DSP & Managers who provide residential services. EX: direct care staff, managers, etc.)

Professional of the Year (Person providing professional supports or services in the community. EX:nurse, attorney, therapist, etc.)

Host Home Provider (A person who lives with and provides direct support to a person with IDD).

Vocational/Day Service Provider (An individual or agency that provides supported employment, day programs, specialized habilitation. EX:job coach, direct care staff, managers, etc.)

SLS/EBD Service Provider (Person or agency who provides supports to a person receiving services from the SLS/EBD waiver).

CES/CHRP Service Provider (Person or agency who provides supports to a person receiving services from the CES/CHRP waiver).

Special Recognition (Someone who supports an individual with IDD and doesn't fall into another category. EX: community members, programs, services, etc.)

Resource Coordination (A person who provides case management or helps coordinate services. EX:case management)

Employer of The Year (Business employing people with IDD).

Other (not sure which category…)

The Arc and the review committee reserve the right to re-categorize nominations.

Who are you nominating for the selected category? (Person, business, program, etc.) *

How can we contact this nominee? *

Nominee Phone Number *

Nominee Email *

Nominee Address *

Nominee Agency & Phone # *

Tell us why we should select this nominee *

Nomination completed by: *

How can we contact you?

Phone *

Email *

Address *

Agency & Phone # *

Can we tell the nominee you made the nomination? *

Captcha *

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Get in touch with us

The Arc Pikes Peak Region
1o North Meade Avenue
Colorado Springs, CO 80909

frontdesk@thearcppr.org

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