Cure Warrior Advocate Award Nomination
Questions marked by * are required.
1.
Full Name of Person Making Nomination *
2.
Email Address of Person Making Nomination *
3.
Confirm Email Address *
4.
Full Name of Nominee *
5.
Professional Affiliation (if any) of Nominee
6.
Nominee *
Is an Individual with Paralysis
Family Member of Person with Paralysis
Other
7.
What specific activities has the nominee participated in to support the cure effort? *
8.
Please explain in your own words how your nominee has earned the Cure Warrior Advocate Award. *