Franciscan Health Community Impact Nomination

Please take a few moments to give us some information about the volunteer you are nominating.  The information you provide here will be used by our panel of judges to choose the recipients of this year’s Franciscan Health Community Impact Award. 

*** If you are nominating more than one volunteer, please complete a separate nomination form for each nominee.  If you would like your volunteers to receive certificates only (not be considered for the award listed above) please see the certificate form located on the Volunteer Recognition Luncheon homepage. 

Award Description

Franciscan Health Community Impact Award
This award recognizes a volunteer who has shown generosity of time and spirit toward the community. It distinguishes those who have a widespread impact throughout the year and over time.


Nominations are due by Friday, MArch 29th.

Questions or Concerns:
Amy Wood, awood@uw.lafayette.in.us

Awards will be presented at the luncheon, Wednesday, April 17th.  You will be notified as to the status of your nomination by April 5th

Please RSVP all who will be in attendance by April 5th on the Volunteer Luncheon homepage.

Feel free to share this form with those in your agency who may wish to nominate a volunteer.