Advocacy Award Nomination Form — FOR Long-Term Care

2023 Sharon C. Wilder Advocacy Award

Online Nomination

Thank you for submitting a nomination for the 2023 Sharon C. Wilder Advocacy Award. The award will be presented at Friends of Residents’ Virtual Fall Gala, Thursday, October 19th, 7:00 to 8:00 p.m.

Deadline for submissions is September 25th.

Section 1: Nominee Information

Name of Advocacy Award Nominee

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

Section 2: Nominator Information

Your Name

Enter the name and contact information of the person nominating this facility.

First Name

Last Name

Your Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Your Email

What is your relationship to the nominee?

Section 3: Nomination Qualifications

Qualifications of Nominee

Summarize achievements the nominee has made protecting consumer rights and improving the quality of long term services and supports in North Carolina. Include employment, volunteer experience or other relevant information about the nominee that supports their selection for this award.