Nominate your CHAMPION today by submitting this application
and the reason why this person is a CHAMPION.
“How My Nominee is Living Like a CHAMPION with a Disability” OR
“How my Nominee Makes a Difference for CHAMPIONS Living with a Disability” Please nominate individuals in these categories:
- BIRTH – AGE 10 *
- AGE 11 – 17 *
- AGE 18 – 25 *
- AGE 25 & OVER *
- CAREGIVER | EDUCATOR | ADVOCATE
*Parent or caregiver may assist in the completion of the nomination.
APPLICATION DEADLINE
All applications must be received by 5:00 PM EST, Monday, August 21, 2017.
CELEBRATION OF CHAMPIONS AWARDS
Champions will be recognized at the awards dinner on
November 5, 2017 Executive Caterers at Landerhaven 6111 Landerhaven Dr. Cleveland, OH 44124
Gold Medal CHAMPIONS and a friend will be our guest at the awards dinner. Each Gold Medalist CHAMPION will receive a personalized award and $500 toward an approved program, service, or adaptive device. Silver and Bronze CHAMPIONS will also be recognized. Each CHAMPION or their representative must be in attendance at the gala event to be honored.
** All entries become the property of NCJW/Cleveland and will not be returned. Submitting an entry grants permission for your entry to be publicized by NCJW/Cleveland whether it is judged to be a winning submission or not. Award recipients’ names and photographs may be used in publicity efforts.
Download application form