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NOMINATION FORM:

Kangaroo Care Team Leader of the Year Award

Please fill out this form to nominate for the award before May 1st, 2023

Join us in thanking the TEAM LEADERS that have made a difference by leading the kangaroo care day celebrations in their units in every corner of the world by nominating them for this award. We will have one winner per country.


Who is a "Kangaroo Care Team Leader"?

A Kangaroo Care "Team leader" is a person that leads the efforts for celebrating, educating, inspiring, and making kangaroo care happen for their team.  You may submit one nomination per Team Leader if there are team co-leaders, and we welcome self-nominations.
* Reason For Nomination (Explain why your nominee deserves the award)
0/500

NOMINEE'S INFORMATION
* Nominee's First Name
0/50
* Nominee's Last Name
0/50
Nominee's Professional Credentials (if any and if known)
0/50
Nominee's Phone Number (Include area code)
0/50
* Nominee's E-Mail Address
0/50
Nominee's Organization Name
0/50
* Nominee's role
0/250
* Nominee's City
0/50
Nominee's State or Province
0/50
* Nominee's Country
0/50

YOUR INFORMATION
* Your First Name
0/50
* Your Last Name
0/50
* Your E-Mail Address
0/50
Your Phone Number (include area code)
0/50
Would you like to add something?
0/500

Thank you for submitting the nomination by clicking the button below.
Submit your nomination
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