GSA for Safe Schools
Judi Devereux Community Activist Nomination Form
Purpose
The Judi Devereux Community Activist Award recognizes an individual that best exemplifies the spirit, vision, values, leadership and transformational activism embodied by the late community activist Judi Devereux, and who contributes to improving the lives of members of the gay, lesbian, bisexual, transgender and queer community in the state of Wisconsin.
The qualities that made Judi Devereux special included her giftedness at gathering together a group and tapping into the power of collaboration and collective creativity that transformed the people involved and made a meaningful impact upon the greater community. She advanced values of connectedness, identity and doing what is right for the greater good. Judi lived boldly and had an enormous capacity to love, laugh, encourage, inspire, take risks, work toward a common goal and envision a world that values and celebrates all members of the LGBTQ community. These are the attributes the GSAFE Judi Devereux Community Activist award was created to honor.
The Judi Devereux Community Activist award, will first be presented in May 2010 and each year subsequently.
Criteria and Application Process
Nominators are asked to recommend candidates who possess a mix of vision, leadership, creativity and unflagging effort which, when combined, produce effective action, tangible achievements and a model for replication within communities. Candidates should not be acting alone, but within the context of an organization, institution or the greater community, and should be considered within that context as an inspirational leader and role model. Candidates should be nominated with the hope that, in receiving this award, their potential for future societal contribution will be enhanced.
Anyone may nominate a candidate, including members of the general public. The GSAFE Board or GSAFE Awards Committee may also solicit nominations for activists who have come to their attention.
Specifically, nominators should answer the following questions:
1. Within what communities does this individual work? How has this nominee provided support, educated others, or improved climate for LGBT and/or other communities?
2. Describe the impact the nominee has had on a school or community and the manner in which she/he/zie accomplished it. Please provide details of any specific achievement. For example, a potential nominee might have promoted trust and worked to create understanding and collaboration across different communities, worked successfully to bring different communities together, started a Gay-Straight Alliance or similar group, or initiated a major campaign or education event.
3. What obstacles, whether personal or external, did this person encounter in carrying out this work and how did she/he/zie work to overcome them?
Nominee Information:
Last Name:
First Name:
Address:
City:
State:
Zip Code:
School (if applicable):
Address:
City:
State:
Zip Code:
Does the nominee know she/he/zie is being nominated? (yes or no):
Nominator Information:
Last Name:
First Name:
Address:
City:
State:
Zip Code:
E-mail:
Phone (including area code:
I verify that the information I have supplied is accurate and true.
You can mail or fax the hard copy of your nomination. Please send nomination materials to:
GSA for Safe Schools
All Judi Devereux Community Activist Award nominations must be received by March 31, 2010 and will be kept confidential.