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2013 Phyllis Campbell Newsome Public Policy Leadership Award Nomination Form

Question Title

* 1.
Nominator Contact Information (Nominators will remain anonymous)

Name *

Organization *

Address 1

Address 2

City

State

Zip

Email *

Phone *

Question Title

* 2.
Where is your organization based?

Washington D.C.

Northern Virginia

Montgomery County, MD

Prince George's County, MD

Question Title

* 3.
Please list the name, title and jurisdiction of the public official being nominated for the Phyllis Campbell Newsome Public Policy Leadership Award:

Question Title

* 4.
Tell us how this public official has shown exemplary work on behalf of nonprofits in their jurisdiction over the past year.