Child Abuse and Domestic Violence Prevention - Long Beach, CA

End Abuse Long Beach
CHILD ABUSE & DOMESTIC VIOLENCE PREVENTION COUNCIL
Since 1975
www.EndAbuseLB.org

CAMFT Approved Continuing Education Provider

ANNUAL AWARD NOMINATION FORM 2016

Child Protection & Domestic Violence Prevention

Each December, End Abuse Long Beach honors community members for their outstanding contributions in the prevention of domestic violence, child abuse, sexual assault, elder abuse, substance abuse or other related issues.
To make a nomination, please complete as follows:

Your Nominee:



      

Your Information:



   

Deadline for submissions to be considered: September 10, 2016

Please fill in, print, sign, and turn in at our meeting, or email this info to Paul@EndAbuseLB.org.

SIGNATURE: ___________________________ DATE: _________________