Mayors Wellness Campaign Champion of Health Application

2024 Champion of Health Form

The Mayors Wellness Campaign recognizes the important health and wellness work being done in your communities would not be possible without the dedication of the individuals moving the MWC and its initiatives forward. We want to provide an opportunity to recognize someone in your town that you consider to be a MWC Champion of Health. This person should be active in the health and wellness activities of your town, and someone who is passionate about improving the lives of your residents. Nominees can be municipal employees, volunteers, or other stakeholders working with your MWC program.

Applications are due on Friday, November 1st at 5:00p.m. and the winner will be announced on Thursday, December 5.

Winners will be:

· presented with a plaque,

· featured on our website, and will be

· highlighted in a press release, newsletter, and social media announcements.

Any town that submits a nominee will be entered into the Incentive Drawing for the chance to win funding towards your programming.

For questions or more information, contact the MWC Community Health and Policy Associate, Katie Bisaha, at kbisaha@njhcqi.org or call 609-452-5980.

Municipality*
Nominating Mayor*
Mayor's Email Address*
Name of Nominee*
What is the nominee’s role in your community? What is their role with your town’s MWC?*
Describe how the nominee has worked to improve the health and wellness of your community. For example, did the nominee spearhead a specific project, go above and beyond their official role, or play an instrumental part in the success of your MWC?*
What makes the nominee uniquely successful in moving health initiatives forward in your community? Use this opportunity to describe your nominee’s qualities that makes them an asset to your MWC team.*
What is the nominee’s biggest accomplishment that affected the health and wellness of your residents? For example, what is a program, policy, or initiative that was successful because of the work of your nominee.*
Upload any supporting material you feel shows the accomplishments of the nominee. Examples include photos, press releases, or program flyers. (Optional)
Max. file size: 50 MB.
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Max. file size: 50 MB.
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Max. file size: 50 MB.
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2024 Mayors Wellness Campaign Champion of Health Nomination

2024 Champion of Health Form