EmailMe Form - 2024 Caregiver of the Year Award

Award Nominee Information

Nominee

Nominee's position

Length of time in this position

Total length of time working in senior care

Facility/Organization

Type of Facility/Organization

City/location

Nominator Information

Full Name of Nominator

This is who we will contact for all information about the nominee/award status

Nominator's position

Email of Nominator/Contact Person *

Phone of Nominator/Contact Person

Administrator/Executive Director

What prompted you to nominate?

If other, please explain:

Please note: If your nominee is selected, you will need to provide photos and videos of your nominee for the award presentation at Convention. Care Providers of Minnesota will be using a free uploading platform for the videos and will provide easy to follow instructions on how to do this!

Will you be able to provide photos and videos?

Yes

No

Caregiver of the Year Award information

Eligible nominees: any SNF/NF, assisted living, home care member.

Award Criteria - please describe (in 1,000 words or less) the following:

How your nominee is a fabulous caregiver, exceeding what is expected of him/her *

Specific examples of your nominee’s exceptional skill in caring for others *

Specific examples of your nominee exhibiting empathy and respect towards others in a care setting *

Specific examples of how your nominee promotes dignity *

Please upload two additional documents that support why your nominee is deserving of this award. These documents should be from sources other than the nominator (i.e., they could be from peers, the organization, residents, clients, tenants, other staff, family members, etc.) *

Please upload the second document here. *