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Diakon Impact Award Nomination Form

The Diakon Impact Award recognizes an individual for exemplary service in their role at Diakon. Their actions benefit clients, residents and fellow team members to enhance the quality of their lives. Their actions live out Diakon’s mission and values and their actions exemplify the DiaKINDNESS philosophy.

Your Name:

Email:

Date:

Team Member Name:

Team Member’s Program and Location:

Please describe the reasons you are nominating the team member for the Diakon Impact Award:

Diakon does not discriminate in admissions, the provision of services, or referrals of clients on the basis of race, color, creed, religion, sex,
national origin, sexual orientation, age, marital status, veteran status, disability or any other classes protected by law.