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2022 People of Courage Award Nomination Form

Awardees will be honored at the Safe Homes Gala on April 8, 2022

Nominator Information (Your Information)

Please fill out the information below for the Safe Homes Advisory Committee. You must be willing and prepared to comment via telephone and provide more detailed information about the nominee. You will only be contacted if your nominee is chosen as a finalist. 

* Nominator Name
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* Nominator Address
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* Nominator Email Address
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* Nominator Phone Number
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Nominee Information

Nominee will only be contacted if they are chosen as a finalist.

* Nominee Name
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* Nominee City/Town
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* Nominee Email Address
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Nominee Phone Number
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* Award Category (Check Only One)
If you selected "Create Your Own," fill in the proposed award category here
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* Does the nominee live or work in Central Massachusetts?
* Does the nominee demonstrate commitment to serving as a role model for LGBTQIA+ youth/adults or other marginalized group?
* Does the nominee show demonstrated commitment to advocating for equal rights and social justice for all?
* Does the nominee show distinguished contribution to LGBTQIA+ youth/adults or other marginalized groups in Central Massachusetts?
* Does the nominee agree to be recognized by Safe Homes for their contributions and this achievement at public events and in the media?
* Tell us more about the nominee - Why do they deserve this award?
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