Award Nomination Form
AWARD NOMINATION INSTRUCTIONS
This award will select recipients to be recognized for their outstanding accomplishments going above and beyond supporting and educating our community about liver health, disease awareness and prevention.
Recipients must meet the following criteria (Staff members are not eligible for nominations):
• Demonstrate commitment and dedication to the Community Liver Alliance’s mission
• Actively advocates to improve the quality of life for those with liver disease throughout the community
• Support the initiatives of the Community Liver Alliance
• Proactively represents the Community Liver Alliance in a positive manner
COMPLETING THE FORM
• Nominations for the Award must be submitted using this nomination form
• To access the electronic version of this form, please visit
• You may include two additional pages of supporting documents (i.e. resume, CV, etc.)
• The information submitted should support the award criteria of the nominee’s achievement, leadership and service to the Community Liver Alliance using 1,000 words or less.
A Selection Committee consisting of a diverse group of Community Liver Alliance supporters from the community will review all nomination forms and select the Award Recipients.
The 2021 You Make a Difference Award will be presented at the virtual program held on
Friday, February 5, 2021 at 4:00 p.m.
DEADLINE FOR SUBMISSION IS Monday, December 14, 2020: