Hunger Action Network of New York State

Homeless Alliance of WNY 2014 Annual Event Award Nomination Form

Please take a moment to nominate a candidate for the following Alliance awards

Check the box corresponding to the appropriate award:

Monsignor Henry Gugino Organizational Service Award ______Killian Vetter Individual Achievement Award ______Unsung Hero ______Other ______

Monsignor Henry Gugino Organizational Service Award: This award recognizes the achievements of an agency or program that has provided exceptional service to homeless persons or toward the elimination of homelessness at its root causes in the past year.

Killian Vetter Individual Achievement Award: This award recognizes the hard work, dedication, and special achievement of an individual who has worked on behalf of homeless persons. Individuals may be a professional service provider, volunteer, governmental official, or any other person actively engaged in work to benefit homeless persons or working toward the elimination of homelessness at its root causes.

Unsung Hero Award:

This award would recognize someone who has done a considerable amount of work for the homeless working diligently behind the scene.

Other: If you have a suggestion for an award, please send the homeless alliance your idea. Examples: Inspiring Public Official, Best Media Story, Outstanding Collaborative Effort. Nominee Information

Individual Name (if Applicable) ______

Agency / Business Name______

Address ______

City______State ______Zip ______

Phone ______E-mail:______

Nominator Information

Your Name ______

Agency / Business Name______

Address ______

City______State ______Zip ______

Phone ______E-mail:______

Reasons for Nomination (Attach additional sheets as necessary)

______

Nomination Forms are due November 11nd at 5pm to:

Homeless Alliance of WNY 960 Main St. Buffalo, NY 14202 Fax: 853-1750 Email: [email protected]