Nomination Form -- Champions for Accessible Living

CARE@Paquin
2009 Champion for Accessible Living
Nomination Form

(e-mail seanspence@earthlink.net for MS Word version of this form)


On Wednesday, June 3rd, CARE@Paquin will recognize one or more Columbians for their work to improve the quality of life for our neighbors with disabilities. Nominations will be accepted from the community and final selections will be made by our panel of judges (nominations are not accepted from members of the panel).

The award(s) will be presented at the “CARE@Paquin Champions for Accessible Living Breakfast” on Wednesday, June 3rd, 7:30-9:00 a.m. at Columbia Country Club, Chaired by former state senator Joe Moseley.

Nominations may be submitted via e-mail at seanspence@earthlink.net or may be mailed to CARE@Paquin, 1106B East Broadway, Columbia, MO 65201. The submission form is available online at www.careatpaquin.blogspot.com. The deadline for submitting nominations is Monday, May 11th (or post-marked by Saturday, May 9th).



Name of Nominee:

Phone Number:

E-mail Address:


Why should the nominee be recognized as a “Champion for Accessible Living?” (attach additional page, if necessary)




Please provide two or more examples of the nominee’s contributions to Columbia’s disability community. (attach additional page, if necessary)




Feel free to include any news articles, letters of reference, or other material that might be helpful in evaluating your nomination.

Your Name (Please Print or Type):

Your Signature:

Your Phone Number:

Your E-mail Address:

CARE@Paquin (Columbia Accessible Recreation at Paquin Tower) is a non-profit organization whose goal is to support accessible recreation programs housed at Paquin Tower. This is a new organization, formed in response to City of Columbia budget cuts to the Paquin recreation program. It is a grassroots organization, building broad-based support for programs that are essential to our community.

CARE@Paquin Board: Dean Andersen, Sarah Catlin-Dupuy, Richard Craghead, Abe Eisenstark, Joan Eisenstark, Nancy Harter, Aaron Perkins, Ines Segert, Sean Spence, Marilyn Starke, Brian Waller

CARE@Paquin Advisory Council: Greg Ahrens, Lee Henson, Barbara Hoppe, Ann Mehr, John Ott, Jerry Wade, Aimee Wehmeier, Kathleen Weinschenk