2021 Outstanding Advocate Award Nomination Form

Nomination Guidelines

  1. To nominate someone please complete this form below.
  2. Candidate must have demonstrated commitment to peace in the family and community for a minimum of twenty years.
  3. Nomination must be submitted by a DVC councilmember or committee member.
  4. Nomination must be received by 5pm on Friday, September 17, 2021.
  5. Awardee and nominator will be contacted Friday, September 24, 2021.
For questions regarding application please contact [email protected] or (408) 678-1499.

Nominee Information


Nominator Information

Nominator Address

Please answer the following questions.

Questions to consider:  
What has the nominee done above and beyond her/his daily job responsibilities to keep victims safe and families healthy? Things to consider include any committee meetings, task forces, trainings, protocol development, or other community action group work.  How is the nominee an inspiration? How does she/he motivate, show leadership in the community and serve clients?  Consider an anecdotal story on how the nominee affected direct services.  Finally, how does this nominee work to keep victims safe and families healthy?  Consider an anecdotal reflection on how this nominee has touched a family.  For example, describe a time the nominee got home and felt like she/he made a difference that day.  

For Conference Committee Use Only.

Available 10/22/21?

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