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Web Nomination Form

Nomination Rules:
A developmental disability is a substantially handicapping condition beginning before age 18, is expected to be lifelong and is attributed to mental retardation, cerebral palsy, epilepsy, autism or conditions similar to mental retardation.

  • Use one nomination form for each nominee in each award category.

  • Do not submit photos, videotapes, or any other material with the Official Nomination Form.

  • You may photocopy this form if you are nominating more than one person. Additional forms can also be downloaded from the RCOC web site at www.rcocdd.com.

  • Nominations of the same person received for two consecutive years without receiving an award, must experience a one year break before being nominated again.   

  • No individual or organization may receive an award more than once in five years.

  • Judges and their immediate families are not eligible.

  • All nominators will be contacted for confirmation of nomination.  

  • Nominations are judged on the information about the nominee and not the quantity of nominations received.   

  • All nominations will be verified.

Consumers who would like assistance completing the nomination form should contact their RCOC service coordinator. 

Please indicate category:

Community Partnership
Consumer
Elected Official
Employer
Health Care Professional
Lifetime Achievement
Living Options Vendor
 
Nick Garrett Award
Parent
Professional Achievement
Support Services Vendor
Volunteer
RCOC Achievement
E. Kurt Yeager Servant Leadership


Nominee Information

Name
Business/
Organization
Address
City
State
Daytime Phone#
Email Address

Your Information (Nominator)

Name
Business/
Organization
Address
City
State
Daytime Phone#
Email Address
 
Type answers to all the questions listed below.
 

1.Describe what the nominee has done to deserve an award in the category you have selected.


2.Describe how this person or organization has had a positive effect on people with developmental disabilities in Orange County.

 

 

 

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