Support Network/Affiliate of the Year Award This award provides an opportunity for embrella to showcase the achievements of a Support Network/Affiliate and how its accomplishments have made a positive and measurable impact on the lives of resource families. The primary criterion for consideration for this award is helping embrella to meet its mission through exemplary work in supporting resource families in the community. INFORMATION ABOUT THE NOMINEE (Please provide as much information as possible.)Name of Support Network/Affiliate being nominated* Name of Support Network Chair or Co-Chair* First Last Email* Phone - Daytime*Phone - EveningNames of Support Network Co-Chair (if applicable): First Last Email Phone - Daytime*Phone - EveningNOMINATOR INFORMATIONYour Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Email* Daytime - PhoneEvening -PhoneAre you a: check all that apply* Foster Parent Adoptive Parent Kinship Parent Caseworker Other YOUR REASONS FOR NOMINATING THIS TEAMIn the space below, please describe your reasons for nominating this Support Network/Affiliate. Mention any specific services provided to resource families in the county during the past year. What has been done to increase awareness of, or attendance at, the Support Network/Affiliate meetings? Describe efforts made to increase embrella’ membership in the county. Has the group tried any new or innovative ideas this year? Provide details of any specific achievements of this group. Please feel free to add any other information that you think will highlight the exemplary efforts of this Support Network/Affiliate over the past year. * Δ
