Women
of Peace Award Nomination
Name:____________________________________________
Address: __________________________________________
City:___________________ State:_____________________
Country:__________________ Zip:____________________
Phone:_____________________ Fax: __________________
Email:______________________________________________
Person
Nominating:
_____________________________________
Contact
Information:______________________________________________
1. Briefly describe your candidate's project/initiative/life's work. ____________________________________________________________
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2. Did the nominee take a personal risk to do her work? Explain.______________________________________________________
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3.
Did the nominee take a financial risk to do her work? Explain.
__________________________________________________________________
_________________________________________________________________
_________________________________________________________________
4.
Did the nominee take a health risk to do her work? Explain.
_________________________________________________________________
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5.
Is the nominee working actively in her community to bring peace to women’s
lives or to work to end violence? Explain.
__________________________________________________________________
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6.
Is the nominee volunteering all or part of her time on the project?
____
full time
____ part time
7.
Does the nominee’s
work impact:
____
locally
____state
____national
____world
8.
Does the nominee demonstrate a selflessness in her commitment to the
changes she is working on in her community? Explain.
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9.
Has
the nominee created a new approach to the problems she is addressing? Explain.
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