Nomination Form: Caring Spirit Awards

Caring Spirit Award Nomination Form

Area Agency on Aging 1366 E. Thomas Rd. Suite 108 Phoenix AZ, 85014 Phone: 602.264.2255 FAX: 602.230.9132 Toll Free: 888.783.7500

CSA The Dr. R. Alice Drought Caring Spirit Awards were established in 1982 in honor of the first director of the Area Agency on Aging, Region One. Dr. Drought served as the Agency’s director from 1974-1981. She worked for many years as an advocate for older adults throughout Maricopa County. Dr. Drought’s lifetime of achievement is honored through the superior accomplishments of the Caring Spirit award recipients.

The Dr. R. Alice Drought Caring Spirit honorees represent a diverse group of individuals and organizations dedicated to improving the quality of life for older adults or special populations*. Their commitment has inspired colleagues, friends and family members. Their achievements continue to provide lasting benefits to residents of Maricopa County.

Please help us thank them with your nomination and participation in the 26th Annual Dr. R. Alice Drought Caring Spirit Awards Luncheon.

*Special populations refer to people of all ages who are HIV positive, people with disabilities or long-term care needs, elder refugees and people in the GLBT community.

Choose a Nomination Category: *

Nominee Information

Nominee's Name: *

Home Address: *

City: *

Zip: *

Home Phone: *

Fax: *

Place of Employment/Service: *

Title: *

Work Address: *

Work City: *

Work Zip: *

Work Phone: *

Work Fax: *

E-mail: *

Your Information

Nomination Submitted By: *

Address: *

City: *

Zip: *

Phone: *

Fax: *

Sender Email: *

Specifically describe the contributions/activities of the nominee: *

Describe nominee’s length of time in service to older adults: *

What has been the impact in the community due to nominee’s contributions?: *

List any credentials or unique qualifications related to nominee’s work or service: *

How is this nominee an exemplary caring spirit?: *

Please list any additional information or provide an anecdote or “special thought”: *

List another person who could verify the impact of this nominee’s efforts

Name: *

Place of Employment: *

Address: *

City: *

Zip: *

Work Phone: *

Home Phone: *

Fax: *

E-mail: *

Relationship to Nominee: *

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