Dennis H. Alldridge Nomination Form

Please complete this form to nominate an individual for his/her outstanding achievements, demonstrated leadership and sustained dedication to furthering the mission of Special Olympics. Submissions should be submitted no later than July 13, 2022.

Nominee Information
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Local Program # and Name:

(if applicable)
Number of Years Involved:*

(The minimum requirement to be considered for this award is at least five (5) years of participation with SOWI.)
How has the nominee helped promote and advance a more inclusive society in his/her time associated with Special Olympics Wisconsin?
How have the nominee’s contributions to Special Olympics Wisconsin made it a more successful organization?
What makes the nominee stand out from others in a similar role in the organization?
Please provide an example of a time when the nominee exemplified extraordinary leadership and dedication to the Special Olympics movement:
Nominator's Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Role in SOWI/Relationship to Nominee:*
Signature*

Special Olympics Wisconsin
2310 Crossroads Drive, Suite 1000
Madison, WI 53718
	(608) 222-1324

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