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Deaf Community Leadership Award Nomination Form

Hamilton recognizes deaf or DeafBlind individuals for their contributions and commitment to enhancing the lives of those around them through the Deaf Community Leadership Award. Concurrent with National Deaf Awareness Week in September, recipients are selected from within each of the states where we are the contracted relay and/or captioned telephone service provider. This includes California, Colorado, Connecticut, District of Columbia, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, Saipan, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, Wisconsin and Wyoming.

We present the Hamilton Relay Deaf Community Leader Award each year during this national celebration – when people gather to honor and celebrate their culture.

To nominate someone in your state, complete the form below.

Or you can download the MS Word document or download the PDF and submit the completed form to your State’s Outreach Coordinator or directly to Hamilton Relay’s corporate office:
Fax: 402-694-5110
Mail: Hamilton Relay, 1006 12th Street, Aurora, NE 68818.

For more information, contact your state outreach coordinator

Candidate Information:
Name of Candidate*
(Please note that this award is presented to one individual within your state each year. Organizations, schools, associations, groups of individuals, and individuals who are deceased are not eligible for this award.)
The candidate
Candidate’s Address
Please check one
Phone Type Other
Candidate Qualifications:
Reference #1
Reference #2
Your Information:
Your Name*

* Required information

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Your Contact Information

* Required information