DVS Catalyst for Change Nomination

The DVS Catalyst for Change Award is presented to individuals or organizations who have made significant contributions to the DVS mission beyond the requirements of professional work to be a catalyst to end domestic violence in Lancaster County through direct service, advocacy or social change efforts.

The selection of the Award winner will be made by a committee comprised of members of the DVS Advisory Committee, the DVS Leadership Team/Staff, the Special Events committee and the DV Awareness Month committee.

Each nomination will be considered on its own merits, but also in relation to other nominations submitted. If the selection committee determines that there is no clear winner or that no nomination meets the established standards, an Award may not be presented for that year.

Please complete the Nomination Form and return to Christine Gilfillan, DVS Director, at cgilfillan@caplanc.org or complete the form below. The deadline for submissions is Thursday, April 6, 2023.

DVS Catalyst for Change

Organization

Name of Individual or Organization nominated(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

“This individual is nominated for the Catalyst for Change Award because . . .”

When answering these questions and responding to this statement, assume the judges know nothing about the nominee, and/or the work they do. Tell the story, keeping in mind the following suggestions: • Specifically reference how the individual embodies the DVS values of Empowerment, Respect, Collaboration, Integrity, Excellence, and Compassion. • Be specific and brief. • Type or print legibly. • No posthumous selections will be made.

What contribution has this individual or organization made toward ending domestic violence in Lancaster County?(Required)

How has this individual or organization been an inspiration to survivors of domestic violence?(Required)

Nominator's Name(Required)

Nominator's Email(Required)

Nominator's Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country