Award – Health Enhancement – Nomination

Victoria Lesbian Seniors Care Society – Rainbow Awards Program

Health Enhancement Award

Nomination Form

To a person whose work enhances lesbian health.
a. who demonstrated experience in gerontology/geriatrics
b. volunteer or professional work in dealing with lesbian health in a holistic way i.e addressing psychosocial, physical, emotional and mental health issues
c. educating, promoting, supporting or creating health care programs

Please complete the nomination form with as much detail as possible as nominees will be scored on how well your submission matches the above criteria. You can nominate as many people/organizations as you like. All information provided by you is private, except where you give authorization for release. For more information feel free to contact VLSCS at awards @

For the VLSCS Health Enhancement Rainbow Award, I nominate:

Is this nominee aware and agreeable to this nomination?

For how long and in what capacity have you known this person/organization?

Why do you think this person/organization should be nominated for this award? Minimum of three detailed reasons required.

Other comments, information or questions.

Your Name (required)

Your Email (required)

Your Telephone Number

Do you wish to remain Anonymous?

Human checking: