Nominee's First Name: Nominee's Last Name: Your First Name: Your Last Name: Non-profit Organization: Your Email Address: Your Telephone Number: Address of Non-Profit Org.: City: State: Zip Code: Tax ID of Non-Profit: Non-Profit Phone Number: Description of Non-Profit: In what capacity do you know the nominee? How long have you known the nominee? Please describe the nominee's work as a volunteer being as specific as possible. Discuss the capacity in which the nominee has served and the duration of service. Why do you believe your volunteer is different from other volunteer in the same role? What makes this nominee different from other volunteers? What sets your nominee apart and makes him/her deserving of special recognition? What impact has the nominee has on the developmentally disabled community? How has the nominee demonstrated sustained commitment? How has the volunteer shown initiative to go above and beyond in the volunteer capacity? How has the nominee shown innovation in his/her approach to support the developmentally disabled population? Additional Comments Security code:   * Do not enter anything in this field: