Sexual Assault Awareness Month Award Nomination Form

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Purpose

Recognize individuals or organizations that demonstrate an extraordinary commitment and service to victims of sexual violence. This award may also acknowledge individuals or organizations that improved the accessibility or appropriateness of systems for victims of sexual violence.

Criteria

Nominees will be judged on their overall contributions to victims of sexual violence and the positive impact (both short-term and long-term) that their efforts have made toward a society in which sexual violence no longer exists.

Nomination Period

Nominations will be accepted at the offices of the Utah Coalition Against Sexual Assault by fax and email, up until and including Tuesday April 4th, 2017.

Conditions

1. Nominators must complete the nomination form in its entirety and provide all supporting documentation.

2. All nomination forms and supporting documentation must be received at the offices of the Utah Coalition Against Sexual Assault by mail at 284 West 400 North Suite 103 Salt Lake City, Utah 84103; by fax at 801-746-2929; or by email at info@ucasa.org no later than 5pm on April 4th, 2017.

3. Nominators may nominate themselves or their agency.

Selection

Individuals from UCASA and a committee of other community and/or board members will review all nomination forms and supporting documentation and select up to five recipients. The individuals selected will be honored and presented with their awards at our Sexual Assault Awareness Month Awards Party on April 28th, 2017. Details for the party are available here. 

Please provide the name of the person you are nominating.

Please ensure proper spelling. The name of the person you are nominating will only go in the large box at the top of the form. Your information will go in the information boxes below the large box.

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