Home → Get Involved → 2019 Standing Up for Mothers and Babies Awards Event → Award Nomination Form
Nominator Name*
Nominator Email*
Nominator Phone*
Partner Organization
Name of Nominee*
Nominee Address*
Nominee Email*
Nominee Phone*
Award Category*
Select one category.
Dr. Terry Leet Researcher Award
Dr. Corrinne Walentik Provider/Practitioner Champion
Alderman Gregory Carter Community Champion
Judy Wilson-Griffin Maternal Health Equity Champion
What contribution has your nominee made to maternal and child health?
Why do you think this person deserves the award?
How does your nominee prioritize racial equity in maternal and infant health?