disABILITY RESOURCE CENTER’S

2006 “SPIRIT OF THE ADA” AWARDS

NOMINATION FORM

Nomination for (Circle One):

Person with a Disability Employer

Most Accessible Business Community Member or Service Provider

Nominee information: Person Submitting Nomination:

Name: _________________________________ Name:__________________________________

Phone: _________________________________ Phone: _________________________________

Organization: ____________________________ Organization: ____________________________

Email: __________________________________ Email: _________________________________

Please tell the Nominations Committee how this individual/employer/business or service provider demonstrates a commitment to the Americans with Disabilities Act (ADA).

What makes this individual/ employer/business or service provider unique?

Return this form by June 30, 2006 to:

Disability Resource Center – 900 E. Hill Avenue, Suite 120 – Knoxville, TN. 37915

Email: drc@drctn.org – Fax: (865) 637-5616 – Phone (865) 637-3666

If this nomination is chosen, who should be added to the invitation list for the award ceremony?

Please provide names and addresses with Nomination Form: