Foster &

Adoptive

Care

Association

Of

Minnesota

 

AWARDS NOMINATION FORM

 

Award Category

______Foster Family                              _____Adult Provider                   _____Service Award

______Foster Child                                _____Adult Resident

______Social Worker                             _____Adult Social Worker

 

 

 

Person submitting Nomination

 

Name_________________________Phone_______________Lic. Agency___________

 

Address________________________City_______________________Zip_______________

 

Person Being Nominated

 

Name______________________________Phone________________Lic. Agency____________

 

Address_________________________________City_______________________Zip_________

 

 

Provide the following information as it pertains to your nominee on separate sheets of paper

 

·          Number of years providing service as foster parent, social worker or adult provider

·          Number of children/adults in care or in caseload

·          Type of children/adults in care or caseload

·          Special skills or out-of-the-ordinary services provided

·          Advocacy and teamwork

·          Previous recognition or awards

·          Involvement in foster care associations – local, state, national

·          School involvement, employment or volunteer activities

·          Participation in conferences – local, state, national

·         Any other pertinent information

 

Service Award

·          List any special service to children, adult residents, foster care providers or FACAM

 

Please attach any letters of support or documents from agency, foster care providers or Community.

 

NOMINATION DEADLINE IS SEPTEMBER 15th

 

If you know of a deserving person or family please consider nominating them for an award. It will be a wonderful way to show them how special they are.