Award Nomination Form 2025 AMCHP Award Celebration

AMCHP Annual Awards Nomination Form

Award Selection

Select the award for which this person is being nominated marking the appropriate checkbox. Please select only one award for each nominee.
Award descriptions can be found linked on our webpage.

Choose an Award(Required)

Vince Hutchins Leadership Award: for leadership in promoting a society responsive to the needs of women, children, youth, and families.

John C. MacQueen Lecture Award: for innovation in the field of maternal and child health. Candidates must be able to record the lecture for distribution during the AMCHP Annual Conference in April 2024.

Merle McPherson Family Leadership Award: for exemplary contributions to further family/professional collaboration within a state Title V Program and AMCHP.

Emerging MCH Professional Award: for outstanding state or local MCH professionals under age 45 or with less than 10 years of experience whose work has made substantial contributions to their state’s MCH program, their state’s MCH outcomes, or made other significant contributions to promoting and protecting the health of women, children, and families in their state or jurisdiction.

Excellence in State MCH Leadership Award: for an outstanding state MCH professional whose career has made significant contributions to the health of women, children, and families in their state or jurisdiction.

Ryan Colburn Scholarship Award: for a young adult who identifies as having complex health care needs or disabilities to attend the AMCHP Annual Conference, grow as a leader in MCH, and continue to honor Ryan’s legacy.

Community Partnership Award: for exemplary collaborations between Title V entities and community-based organizations. Partnerships provide the maternal and child health workforce with data to identify community needs and the perspectives necessary to promote health service utilization through community-rooted solutions. This award uplifts the importance of sustainable and outcome-focused partnerships in promoting the dignity and overall well-being of communities.

Nominator Details

Please provide information about the person submitting this Nomination

Nominator Name(Required)

First Last

Nominator Email(Required)

Nominee Information

Please provide all information requested. Awardees that are not selected will not be notified.

Name of Nominee(Required)

Credentials

Job Title(Required)

Organization(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

Fax

Email(Required)

We need all your contact information so we can verify your membership and send you a notification of the award selection outcomes. You will be notified about the final disposition of your nomination regardless of the outcome.

Nomination Requirements

Each nomination package MUST include:
Nomination summary OR Nomination Video
Photo of the Nominee
Resume/CV for the nominee OR a letter of recommendation from the nominator

Nomination Summary

Please include a brief narrative in support of this nomination while listing the nominees’ specific contribution to MCH and address any specific criteria required by each award as stated in the award description. Other accompanying materials may include CVs, letters of recommendation, etc.

Attach Nomination Summary

Drop files here or

Max. file size: 50 MB.

Please ensure that the narrative is:

No more than three pages in length
12pt Font, Times New Roman, double spaced
DO NOT CUT AND PASTE A CV OR RESUME INTO THIS SUMMARY

In lieu of a narrative, nominators can submit a brief video or audio file that serves the same purpose as the nomination narrative. Like the narrative, the video must address any specific criteria required by each award as stated in the award description. Mp4 files are preferred; videos or audio narratives should not exceed five minutes. Video / audio nominations should include any required supporting materials for the award as stated in the award description.

Supporting Materials

In addition to the narrative, please include any supporting material as an attachment to this document including:

A resume or CV for the nominee.
A photo or link to a headshot of the nominee suitable for use in website and print publications. Photos will not be used for selection purposes.
Other documents or examples of materials that support your nomination (link to accomplishments and resources on websites is preferred rather than actual documents themselves).
Some awards require letters of recommendation or other accompanying documentation, so please reference the exact criteria required by each award as stated in the award description.
For the John C. MacQueen Lecture Award, you may include links to any online lectures or presentations delivered by the nominee that the selection committee should consider. You may include these in your three-page narrative or as a separate page in supporting materials.
For the Community Partnership Award, you may include publications or materials created as part of the partnership.

Please note that the quality of supporting materials, not the quantity of supporting materials, will be used as a review criterion. Only the material you submit will be used in the review of the candidate and no other materials will be reviewed or researched by the selection committees.

Attach Supporting Materials

Drop files here or

Max. file size: 50 MB.

Self-Nomination

Self-nominations for awards are accepted with 2 references. Self-nominations may be submitted via written narrative OR audio / video submission.

Attach Self-Nomination Materials

Drop files here or

Max. file size: 50 MB.

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