Distinguished Resident Award - Idaho Health Care Association
Distinguished Resident Award - Idaho Health Care Association
Distinguished Resident Award - Idaho Health Care Association
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
IHCA‐ICAL Hall of Fame“<strong>Distinguished</strong> <strong>Resident</strong> <strong>Award</strong>”APPLICATION FORMCircle one: Skilled Nursing Assisted Living Intermediate <strong>Care</strong> FacilityNOMINEE INFORMATIONNAME:FACILITY THEY CURRENTLY RESIDE IN:WILL THIS INDIVIDUAL BE ABLE TO ATTEND THE AWARDS LUNCHEON? Yes NoNOMINATED BYNAME:RELATIONSHIP TO NOMINEE:SIGNATURE:CONTACT INFORMATIONFACILITY:PHONE #:EMAIL:(MUST include name and signature of nominator for application to be processed)Please attach your nomination letter (not to exceed 1 page) giving specific examples of the actions,activities and behaviors of the individual. For example: explain how this resident made a specialcontribution to society or has unique notoriety.Return the application and letter no later than June 1, 2011 to:Danette HuntEmail: danette@ihca‐ical.org; Fax: 208‐342‐6891Mail: 1524 W. Cayuse Creek Drive, Meridian, ID 83646
Change language