NOMINATION FORM for SPECIAL RAP AWARDS
2017NOMINATION FORM for SPECIAL RAP AWARDS
AWARDS AVAILABLE: Please check Award for which you are making a Nomination.
____Dr. PeckhamAward (Activity Director of the Year)____Jean Lyttle Spirit Award
____Administrator of Year ___Activity Assistant of Year
___Volunteer of Year Award
Each individual is limited to two (2) Award Nominations. (Please fill out all information applicable for the Award(s) for which you are making a Nomination.) Please feel free to copy this form if you are making more than one nomination.
Nominee Name______
Home Address ______
Home Phone ______
Facility ______
Facility Address______
Facility Phone Number______
Describe outstanding abilities, leadership contribution, programs, etc. of Nominee:
______
Number of Years Nominee has been a Member of RAP ______
- (This information does NOT apply to Volunteer & Administrator Awards)
Nominee must be an active RAP member for 2 years
Excluding Volunteer and AdministratorAwards
Number of Years Nominee has worked in Long-Term Care______
- Please fill out for ALL AWARDS.
List Associations she/he is a member of: (example: RAP, NAAP, NCCAP, District Round Table, etc.)
1.______2.______
3.______4. ______
5.______6. ______
Committees she/he has served on: ______
______
List Nominees Professional Accomplishments and Educational Background:
______
Signature of Person Submitting Nomination______RAP # ______
PLEASE DO NOT LEAVE ANY BLANKS AS THIS WILL AFFECT SCORING FOR AWARDS.
RETURN not later than September 15, 2107 to:
The RAP Office
PO BOX 336
Lebanon, OH 45036OR YOU MAY FAX THIS FORM to 513-228-0026
See Reverse Side of This Form for Criteria for Awards
RAP AWARDS to be presented at 2017 Conference Awards Luncheon
NEW FOR 2017: JEAN LYTTLE SPIRIT AWARD- This award is presented to an individual that exemplifies the dedication and contribution to those affected by dementia. This individual caringly supports cognitive appropriate activities for all levels and enhances quality of life and ensures residents rights for those that can no longer speak for themselves.
Dr. Charles Peckham Sr. Award - This Award marks the highest merit in the field of Activities by a RAP Member. It honors the recipient’s contribution to the health and therapeutic care areas that exemplify an Activity Professional’s dedication and service demonstrated by their accomplishments at the facility or agency as well as their leadership in the local, state, and National Activity Associations. This nominee must currently be working in the profession, active in promoting the Activity Profession and must have been an ACTIVE RAP MEMBER for the past FOUR CONSECUTIVE YEARS. The nomination must be made by a RAP member or Administrator. (NOTE: This is the only award for which current Board Members may be nominated.)
ACTIVITY ASSISTANT OF THE YEAR
This award is presented to an Activity Assistant that is a self starter, is dependable, and can fill in for their Activity Director at a moment’s notice. This individual not only carries out the activities but can come up with and implement their own activities. The activity department couldn’t function without this individual. This Nominee must work under a current RAP MEMBER. The nomination must be made by a RAP member.
ADMINISTRATOR OF THE YEAR
This Award is presented in recognition of an Administrator that has gone above and beyond to help support their Activity Director in the field of activities. They not only support the Activity Department, but can be found helping out in various ways, even dressing up for the occasion. This nominee must be the Administrator of an ACTIVE RAP MEMBER. The nomination must be made by a RAP member.
VOLUNTEER OF THE YEAR AWARD - This Award is presented to a VOLUNTEER who is directed by a current RAP Member. This award recognizes the tremendous values of people willing to give their time and talents to others. This is an honor given to an outstanding individual who has freely given themselves to the Residents. Nominations must be made by a CURRENT RAP MEMBER.
(Adopted at April 12, 2010 RAP Board Meeting)