“Deaf Person of the Month” nomination form               
You are welcome to nominate someone you know for consideration as a future Deaf Person of the Month.  This can be a teacher, counselor, businessperson, artist, performer, athlete, community advocate, professional, mentor, friend, etc. N.B.—This doesn’t have to be someone you know personally.

In the box below, please explain why you want to nominate this person as Deaf Person of the Month.  This person should fulfill our criteria.  S/he must be currently active in his/her career, and have good standing in the Deaf community.  S/he should be having a positive impact on the Deaf community, improving the quality of life for Deaf people.  S/he should be deserving of this honor.

Please fill out the form on the left (your data) and as much data about the nominee as you can (on the right).  We will not share your address or any personal data with any outside firm.  Your communication will be kept confidential.

A few rules:

* No self-nominations.
* No joke nominations.
* Nominator must include a brief explanation of why the nominee is deserving of the honor.
* All nominations are subject to MSM Productions, Ltd.’s approval. We reserve the right to screen them and to reject any nomination at our discretion.
Nominator (You)
First name: 
Last name: 
Address: 
City: 
State: 
ZIP Code: 
E-mail: 
Nominee (Deaf Person of the Month)
First name: 
Last name: 
Address: 
City: 
State: 
ZIP Code: 
E-mail: 

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