2023 Quetzal Nomination Form

(DEADLINE TO RECEIVE NOMINATIONS IS THURSDAY, AUGUST 24, 2023)

**The Quetzal Awards honor individuals and organizations who demonstrate an ongoing commitment to engage with and help improve the wellness of the Latino Community.**

Is this for an

Individual

Organization/Agency

In which of the Quetzal Award categories is your nominee doing the advocacy work for Latinos? Please select ONE. If their work spans across categories please select the one that is the closest match and explain how they work in more than one category in the narrative.

HEALTH (includes all health categories such as health, mental health, health education, etc)

EDUCATION (includes education of youth or adults)

YOUTH DEVELOPMENT (any age of youth, generally up to 26 years old)

Name of Nominee (individual name or organization name)

Title (if applicable)

Organization (If nominating an individual fill in the organization with whom the individual is associated if applicable)

Nominee email address

Nominee phone number

Briefly answer the following questions regarding the nominee so we may understand why you think this person/organization is deserving of a Quetzal Award. If selected, the information you provide may be read at the Awards portion of the event.

Please summarize why you feel the nominee should be selected to receive the Quetzal Award. Describe the work the person or organization has done. The more information you provide, the better the selection committee will understand why the nominee should be selected.

Describe how this individual or organization has made a difference in the Latino/a community. Why do you think they or the organization are deserving of a Quetzal award?

Approximate number of years working in or for the Latino/a community?

If you were to select some key words or phases to describe this person or organization what would they be?

We may need to get in touch with you to gather additional information on the nominee.

Please provide your contact information below so we may contact you if necessary.

Name of person nominating

Title and/or organization (if any)

Email where you can be reached

Phone number where you can be reached

Thanks for submitting!

2023 Quetzal Nomination Form

El Concilio de Liderazgo Latino

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