Mayor's Disability Awards Nomination Form

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Tempe Mayor's Disability Awards 2019
Nomination Form
Deadline:  4 p.m., Thursday, February 28, 2019

We hope you will take this opportunity to submit nominations to recognize businesses, agencies, educators, individuals and students who demonstrate ability, advocacy, access and achievements for this annual awards event. You are invited to submit more than one nomination.  

The Tempe Mayor’s Disability Awards celebration will be March 26, 2019, from 3:00 to 5:30 p.m. at the Tempe Center for the Arts, 700 W. Rio Salado Parkway, Tempe, AZ 85281.

Contact Michele Stokes at 480-350-2704 or via email at Michele_Stokes@Tempe.gov
for alternate formats or to submit applications via email.

 Eligibility Requirements:

  • Nominees must demonstrate ability, advocacy, access or achievement in Tempe.
  • Eligible nominees recognize inclusion and commitment of people with disabilities.
  • Nominees must work, live, volunteer or impact people with disabilities in Tempe.
  • Businesses/Agencies/Organizations must be located in or conduct business in Tempe.
  • All information must be accurate, current, and include sufficient contact information.
  • Current City Officials and Disability Commissioners are not eligible.
  • Winning nominations will be asked to submit three pictures for the presentation.
  • Nominations must be received by 4 p.m. February 21, 2019.

Award Categories

Education

Exceptional Educator -- Honors a teacher, school staff member or school support person who has provided exceptional education and support to students with disabilities.

Outstanding High School Student -- Recognizes outstanding Tempe students with disabilities in their final year who demonstrate dedication and success as a student, employee, or volunteer. 

Outstanding Youth -- Recognizes outstanding youth with disabilities who demonstrates dedication and success as a student or volunteer. 

Business and Employment

Tom Ringhofer Architectural Award -- RRecognizes a Tempe business, resident, architect, developer or city department that has improved access for people with disabilities in private or public buildings, outdoor spaces, transportation, or other areas.

Business Leadership Award -- Recognizes a business that has improved access opportunities for Tempe residents with disabilities.

Employer of the Year -- Honors a Tempe business or organization that employs individuals with disabilities.

Employee of the Year -- Honors a Tempe employee or resident who has demonstrated exemplary performance or provided outstanding employment services for people with disabilities.

Community Support and Volunteering

Community Service -- Honors a person, organization or business that has made a significant contribution by providing or improving personal and community support for individuals with disabilities.

Pride of the City -- Recognizes an individual, group, business or organization that has demonstrated a long-term commitment in improving the quality of life for all the residents of Tempe.

 

Selection Criteria

Nominations are selected by an independent committee based on the application, please provide complete information and attachments, as needed.

All nominations must be received by 4 p.m., February 21, 2019. Materials submitted will not be returned.  If you have questions or wish to submit a nomination in another format, on paper, in person or via email, please contact:

Michele Stokes, Tempe ADA Compliance Specialist
Phone:  480-350-2704
TTY:    711
Fax:  480-350-2907
Mail:  Michele Stokes, Diversity Office, 31 E. Fifth St., Tempe, AZ 85281
E-mail:  michele_stokes@tempe.gov

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This nomination is for the following category:
This nomination is for the following category:
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Nominee's Contact Information.  If Nominee is 18 or younger, please include parent/guardian's contact information.
Nominee's Contact Information. If Nominee is 18 or younger, please include parent/guardian's contact information.
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Nominee's School/Employer/Organization's name, address and contact information (where applicable)
Nominee's School/Employer/Organization's name, address and contact information (where applicable)
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Accommodation Information

Accommodation Information - Access and cultural accommodations are available. The facility and stage are wheelchair accessible. CART, Listening System and ASL Interpreters are provided. Program will be in large print. This event is smoke-free and fragrance-free; Food may include foods prepared in locations containing dairy, wheat or nuts. Vegan selections will be available. If accessible parking is needed please let us know as there is construction next to the facility and parking is not close.
Accommodation Information Accommodation Information - Access and cultural accommodations are available. The facility and stage are wheelchair accessible. CART, Listening System and ASL Interpreters are provided. Program will be in large print. This event is smoke-free and fragrance-free; Food may include foods prepared in locations containing dairy, wheat or nuts. Vegan selections will be available. If accessible parking is needed please let us know as there is construction next to the facility and parking is not close.
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Description of Nominee and Criteria

Describe the nominee and include criteria or examples showing why this individual or organization exemplifies a commitment to ability, advocacy, access or achievements in promoting equal opportunity and advancement of people with disabilities in Tempe. (Consider: impact, change, improvements, enhancement, achievements, progress, etc.)

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Additional Details:

Provide any other details that would further support this nomination. (I.e. background information of nominee, leadership, inclusion activities, duties, obstacles encountered, considerable contributions, time commitment, achievements, etc.)

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Challenges:

Describe particular challenges the nominee navigated in implementing activities and accomplishments, or any other notable information.

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Additional Comments:

Provide any additional comments that further indicate support of ability, advocacy, access and achievement. 

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Letters of Reference or support (Optional):
Letters of Reference or support (Optional):
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Letters of Support (Optional)

If there are there letters of reference or support, please email them to Michele_Stokes@Tempe.gov or fax them to 480-350-2907. Please ensure that the nominee’s name is included on the letter and/or email title.

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Nominator Information:
Nominator Information:
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