Home | Search | Services | Resources | Advocacy |  Consumers |  Employment 
  Newsletter | Computers | Famous | About Us | Contribute | Contact Info

Michael Lechner Award Nomination Form 

Name of Nominee:

Nominee’s Title/Organization (if applicable):

Nominee’s disability:

Address:

Telephone:

E-mail (if available):

Summary of the nominee’s advocacy activities including: the issue/situation; nominee’s activities that improved the condition or situation; and the geographic area of Kansas in which the improvement occurred (attach additional pages if needed).

Your Name:

Title/Organization (if applicable):

Address:       

Telephone:

E-mail (if available):