Caribbean Philanthropic Alliance – Caribbean Philanthropic Alliance

Nomination form

Nominator Information

Please complete the information below:

First Name

Last Name

What best describes you?

Foundation

CSR & Cooperate

Change Maker

Industry Supporter

Individual Supporter

Contributor/Donor

Affiliated with Caribbean Philanthropic Alliance

Outside of Caribbean Philanthropic Alliance Network

Youth/Youth Hub

Regional Network

Other

Email Address

Nominator Telephone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Award Categories

SELECTION: Caribbean Philantropic Alliance will select (7) woman who live in and/or have influenced the Caribbean while living elsewhere. We share our selection categories of excellence below.

Award Category

Philanthropic Spirit IMPACT Awards

Women & Earth IMPACT Award

Afro-Caribbean & Latin American Diaspora Impact Award

Partnership IMPACT Award

Outstanding Young Woman in Leadership IMPACT Award

EmprowHer IMPACT Award

EntrepreneurHERship Innovation Impact Award

CANDIDATE’S NAME AND PERSONAL INFORMATION

First Name

Last Name

Nominee Email

Nominee Telephone Number

Beneficiary Country

Additional Country

Yes

No

Additional Countries Name(s)

Core Focus Areas

Name of Nominee’s Organization/Entity

Endorsement

A minimum of one (1) Endorser is required for nomination. Please include their names and details below.

First Name

Last Name

Work Telephone

Cell (Telephone)

Email

Nominee Project/Work/Contributions

In no more than 100- 250 words, summarize the Nominee project and how you believe it has influenced or currently impacting the Caribbean/Latin America/Diaspora Communities on a sustainable level:

How can this award expand or scale the work of the Nominee?