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Legacy Leaders Circle Awards Nomination

Legacy Leaders Circle Award Nomination Process

  • Nominations are due by Tuesday, January 24, 2023.
  • The Legacy Leaders Circle Committee submits its recommendations for Legacy Leader Circle Award recipients to the ANCOR Foundation Board for consideration and approval.
  • The nominator will be contacted regarding the final decisions by February 11, 2023.
  • If your nominee is selected, the nominator will receive instructions to prepare for the awards presentation as well as conference details to arrange travel for the award recipient.
  • The awards presentation will be held on April 26, 2023, at the ANCOR Annual Conference. 

Please complete the form below to submit your nomination for a 2023 Legacy Leader Award. Submissions are due by Tuesday, January 24, 2023.

Legacy Leader Circle Award Submission

Nominator Information

Name(Required)
Numbers only. No parentheses or dashes.
Numbers only. No parentheses or dashes.
Address(Required)
Nominator Criteria(Required)

Nominee Information

Name(Required)
Numbers only. No parentheses or dashes.
Numbers only. No parentheses or dashes.
Address(Required)
Posthumous Nominee
Check here if distinction is being submitted posthumously.
Accepted file types: jpg, png, Max. file size: 5 MB.
For publicity purposes, submit a digital photograph (headshot) of the nominee. PNG or JPG only. Max file size 5 MB. If you are experiencing issues attaching a photograph to this form, then send it via email to [email protected]
Estimated duration of ANCOR Membership. If available, please include membership start year and end year.
Identify and describe at minimum three ways the nominee’s time and/or talents have resulted in a positive legacy for ANCOR and its members. We encourage you to consider the ripple effects the nominee’s actions have had on the individuals, the organizations, and the community at-large. (500 maximum word length)
Nominee Engagement(Required)
If the nominee knows of the nomination, indicate how the identified nominee wishes to continue their ANCOR engagement.

Submission

Terms of Nomination(Required)
Electronic Signature(Required)
Date(Required)
Electronic Signature(Required)