Community Builder Award Nomination

Community Builder Award Nomination Process

The ANCOR Foundation Awards & Recognition Committee will review submissions.
Preference will be given to nominators who are ANCOR members and/or nominees that have an explicit ANCOR member connection.
The committee may request additional documents to support the application.
The committee has the right to identify up to three finalists.
The committee will interview the finalists virtually.
The committee may recognize one award winner per year.
The committee will email the applicant of their status within 60 days (about 2 months) of the conference.
The ANCOR Foundation will offer the Community Builder Award winner(s) one plane ticket and one hotel room night to ANCOR Connect ‘24 in Santa Fe, New Mexico to formally receive their award.
Finalists are expected to participate in an interview (on the computer or in-person) with members of the selection team. Also, a site visit may be conducted by the ANCOR Foundation.

Note: ANCOR provider members are not eligible to receive this award but are encouraged to nominate community partners.

Questions? Email Sasha Sencer, ANCOR’s Director of Education & Intersectional Collaboration.

Please complete the form below to submit your nomination for a 2024 Community Builder Award. Submissions are due by Friday, February 2, 2024.

Community Builder Award Submission

Nominee Information

Name of Community Partner(Required)

Organization Name

Name of Initiative (if applicable)

Website of Community Partner(Required)

How does the community partner's mission and values align with the Foundation's mission and values? Please demonstrate how the nominee is committed to developing person-centered initiatives that encourage active and meaningful community engagement for individuals with I/DD.(Required)

Please describe the initiative/activity being nominated, including a timeframe of activity. (200 word maximum)(Required)

How does the initiative create a culture of inclusivity and belonging? Demonstrate how individuals feel comfortable sharing their ideas and concerns with transparency and confidence, feel valued, respected, accepted, and appreciated for their unique characteristics, are treated with respect, treat others with dignity and respect, and use of inclusive language practices.(Required)

How does the initiative support individuals from a wide variety of backgrounds?(Required)

How does the initiative solve a problem or create a unique benefit? Share how the initiative encourages a culture of curiosity or provides a new solution to a current problem.(Required)

How the can initiative can be replicated in other communities?(Required)

Declarations of Support(Required)

Drop files here or

Accepted file types: pdf, mp4, mov, Max. file size: 31 MB.

Please provide no more than two declarations of support from a community member noting the worthiness of this initiative for the 2024 Community Builder Award. Declarations of support can be in the form of 1) a letter of recommendation written and signed by the community member endorsing the nominee, and/or 2) a short video testimonial (not to exceed two minutes in duration) from the community member endorsing the nominee. Letters of recommendation should be submitted in PDF format, while video testimonials should be submitted in .mp4 format.

Contact for this Submission

Name of Nominator(Required)

First Last

Pronouns

Organization(Required)

Job Title(Required)

Email(Required)

Phone (Work)(Required)

Numbers only. No parentheses or dashes.

Phone (Mobile)

Numbers only. No parentheses or dashes.

Address(Required)

Street Address Address Line 2 City State ZIP / Postal Code

Is this a self-nomination?(Required)

Yes

Is the nominator an ANCOR member?(Required)

Yes

Submission

Electronic Signature(Required)

First Name Last Name

Date(Required)