Legacy Leaders Nomination

Revised in 2024, the Legacy Leaders Hall of Fame honors long-time ANCOR members whose vision and service have strengthened our association and the broader disability community.

Please complete the form below to submit your nomination for induction into the 2025 Legacy Leaders Hall of Fame. Nominations are due by November 7, 2025.

If you have questions about the nomination process, please contact Sasha Sencer at [email protected].

Nominator Information

Name(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

Relationship to Nominee(Required)

Nominee Information

Name(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

Years of service in the field of IDD(Required)

20+ years required for eligibility. If fewer than 20 years, please consider nominating for the Rising Star Mid-Career Impact Award instead.

Please share how the nominee has strengthened ANCOR and our community. Describe at least three ways their time and talents have created a lasting legacy—whether through service to members, contributions to our mission, or ripple effects that reached individuals, organizations, or the broader field.(Required)

(500 maximum word length)

Posthumous Nominee

Yes

Check here if distinction is being submitted posthumously.

Nominee Photo

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].

Letters of Recommendation(Required)

Drop files here or

Accepted file types: doc, docx, pdf, Max. file size: 5 MB.

Please attach two letters of recommendation from current ANCOR members in support of this nomination. If you are experiencing issues attaching files to this form, please email your letters to [email protected].

Nominee Engagement(Required)

The nominee DOES know that they are being nominated.

The nominee DOES NOT know that they are being nominated.

Submission

Electronic Signature(Required)

First Name Last Name

Date(Required)