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2017 Family Nomination Awards

This form serves to nominate families and individuals in San Bernardino County for Family Assistance Program's Celebration of Families Gala and Awards Show. As such, those who are nominated must be current residents of San Bernardino County.

Your Contact Information

As the individual nominating a family or individual for an award, please provide your name and contact information. Should you prefer to remain anonymous to your nominee(s), please check the box below.

Annonymity

If you would like to remain anonymous to your nominee, please check "Yes" below. Please note, your information will be visible to Family Assistance Program employees.

Yes, I would like to remain anonymous

No, you can share that I am a nominator

Name

First Name

Last Name

Verify Email

Phone

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Award Descriptions

Mentorship Award- This award is presented to an individual or family who has worked toward the betterment and success of others in the community.

Service Award- This award is presented to a family or individual who dedicates time and efforts towards serving others and/or the community.

Overcoming Adversity Award- This award celebrates a family who has triumphed over hardship, illness, loss, or unique challenges.

Empowered Youth Award- This award is bestowed upon youth(s) who drives change, empower others, or achieve successes despite their age.

Extraordinary Family Award- Presented to a family who is extraordinary due to unique efforts, talents, or bond.

Nominated Individual or Family's Name

First Name

Last Name

Nominee's Email

Verify Email

Nominee's Phone

Nominee's Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

File Upload

Please write an in depth description as to why you feel the person or family you are nominating deserves this award. Your file can be uploaded here. If you prefer, you may use the description box below to type directly into the form.

Why does your nominee deserve the award?

If you prefer, you may type why your nominee deserves the award in the box above instead of uploading a file describing why.