Katharine F. Erskine Award Nomination Form

All nominees must demonstrate a commitment to the YWCA mission –eliminating racism, empowering women and promoting peace, justice, freedom and dignity for all – and meet the following criteria: 1) demonstrated commitment to racial equity; 2) demonstrated commitment to gender equity; and 3) live and/or work in YWCA’s geographic service area which includes all cities/towns in Central Massachusetts.

You may re-nominate candidates who were nominated in previous years and did not receive the award. Members of the YWCA Board of Directors are not eligible for nomination. Nominees are not notified unless they are selected to receive the award

Nominee Information
Nominee Name*
First Last
Title*
Employer*
Employer Address
Street Address Address Line 2 City State ZIP Code
Nominee Email*
Nominee Phone*
Nominee Home Address*
Street Address Address Line 2 City State ZIP Code
Nominator Information
Nominator 1*
First Last
Title
Employer*
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Your Email*
Your Phone*
Your Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Nominator 2
First Last
Title
Employer
Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Your Email
Your Phone
Your Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Nomination
Complete the nomination form below. Please type your response in the box provided. You may include additional supporting materials, if relevant to the nomination e.g. resume or curriculum vitae, articles, letter(s) of support (limit to 2).
1. Please provide a brief biography of your nominee. Include current business title, employer, educational and professional background, and activities that illustrate their commitment to the YWCA’s mission of eliminating racism and empowering women. Be certain to include any current or past involvement with the YWCA Central Massachusetts. Information will be used in publicity/promotional materials. (Answer limit: 500 words)*
2. How has your nominee demonstrated their commitment to racial justice? Please give specific examples of how they have demonstrated exceptional courage, strength, leadership, and commitment to advancing social justice and the human rights of members of marginalized racial, ethnic, and Indigenous communities, and combating systemic racism, discrimination, and xenophobia. (Answer Limit: 750 words)*
3. How has your nominee demonstrated significant leadership, achievement, advocacy, or service in support of gender equity or women’s empowerment. Please give specific examples of how they have uplifted other women, used their voice, mentored girls, or strengthened policies, practices, attitudes, or actions that contribute to gender equality. (Answer Limit: 750 words)*
4. Is there anything else the Nomination Committee should know about your Nominee?*
Supporting Nomination Materials
You may upload additional supporting materials, if relevant to the nomination (e.g. brief biography, resume or curriculum vitae, articles, letters of support). – Limited to 2 letters of support and an additional submission.
Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 64 MB, Max. files: 5.
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Katharine F. Erskine Award Nomination Form

Nominee Information

Nominator Information

Nomination

Supporting Nomination Materials