HANCOCK COUNTY COORDINATING COUNCIL
COMMUNITY IMPACT AWARD
NOMINATION FORM
The Hancock County Coordinating Council Executive Committee was pleased to establish the
Community Impact Award in 1995. The purpose of the award is to recognize an individual in
Hancock County who has significantly impacted the community and provided outstanding
contributions to the social service field.
An individual nominated for the award must be an individual member or an employee of an
agency member, in good standing, of the Hancock County Coordinating Council. The award will
consist of $200 to be divided equally between the winner and their agency. In the event the
agency cannot accept monetary gifts, the award will be donated to the charity of the winner’s
choice. The award will be presented at the November meeting each year.
The selection committee will accept nominations through November 15.
Directions for Submission
• Fill out nomination form completely indicating who you are nominating and reasons for
the nomination.
• Submit completed nomination form by November 15 by email.
• Please send nominations to Jennifer Hunker at jhunker@ffchelpmegrow.org.
Name of Person Nominated:
Agency Name:
Agency Address/City/Zip:
Agency Phone:
Email of Nominated Person:
Name of Person Nominating:
Email address of Person
Nominating:
Reasons you feel this person
should be recognized for
outstanding community
contributions:
Coordinating Council CIA Nomination Form 1