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Life Without Limits Inspiration Awards Nomination Form
Nominator Information
Name
*
Address
*
City, State, Zip
*
Phone
*
Email
*
Nominee Information
Name
*
Address
*
City, State, Zip
*
Phone
*
Category
*
Ages 3 to 12 Years
Ages 13 to 21 Years
Describe the major factors that make this person outstanding. (Limit 1000 characters)
Describe how this person is a role model for becoming independent, productive or integrated into community and school. (Limit 1000 characters)
Describe how this person has shown determination while facing adversity and challenges. (Limit 1000 characters)
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