T. Roy Adams Humanitarian of the Year Award Nomination Form

For applications made this year, the three runners up will automatically be forwarded to the next two years.

Submissions will be judged on an evaluation matrix.

Request a hardcopy nomination form.

Nomination Deadline: March 31, 2017

* = Required

Nominee Information

Sponsorship

Nominees will remain eligible for three years. Applications made for this year, the three runners up will automatically be forwarded to the next 2 years.

This Nominee is being Sponsored By:

Nomination Details

Supporting Documentation

You may attach additional letters of support to be included in your application.

Verify your Submission

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