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) please see the certificate form located on the Volunteer Recognition Program homepage. 

You may also submit a video instead of filling out this form. In the video, please answer the questions asked in the form. To submit the video use WeTransfer and send to estorey@uwlafayette.org.

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, MAY 22ND.

Questions or Concerns:
Elyse Storey at estorey@uwlafayette.org

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