Genie Hayes Nomination Form - Healthy Charlotte Alliance

Please complete the form below to nominate your candidate for the Genie Hayes Award.

Deadline for nominations is February 15.

Nominee Name*
First Last
Nominee Email*
Enter Email Confirm Email
Nominee Phone*
Nominee's Background:
Please share why you believe this nominee is most deserving of the Genie Hayes award. Please include examples of leadership skills, activities, and long-term commitment to the Alliance.*
What other volunteer positions has nominee held in the community?
Person Making Nomination
Name*
First Last
Email*
Enter Email Confirm Email
Phone*