2021 Henry Viscardi Achievement Awards

 

Please complete and submit this nomination form no later than September 17, 2021 at 5:00 p.m. ET. Late, faxed or mailed submissions will not be accepted. Please note the designated word limits for the essay responses as only the designated amount of words will be considered.


If you have additional questions, contact Emily Demarest at info@viscardicenter.org or 516.465.1548.


By submitting an application for these Awards, applicants authorize and approve the use of their name, nomination content, expressions and likeness in marketing, public relations and outreach efforts associated with the Awards program.

*To avoid conflicts of interest, board members and employees of The Viscardi Center and its network of organizations, i.e. Abilities, Inc., Henry Viscardi School, etc., are ineligible.*

 

Award Nominee Information

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Nominator Information (if not the Award nominee)

 

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* Please let us know how you heard about the Henry Viscardi Achievement Awards:
(Select one of the available choices or enter a different value.)



 

Essay Questions

These questions may be answered by the individual being nominated or the person submitting the nomination for the Award.

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