Awards Nomination Form

Virginia Animal Control Association

Providing a united voice for Animal Care & Control Professionals throughout Virginia!

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Submitter phone *

Thank you for your submission!

Full Name/title of Nominee: *

Submitter Phone:

Supervisor Name & Contact #: *

Submitter Email: *

Nominee full address: *

Submission Date

Upload File

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Submitter email *

Supervisor Name & Contact Number *

Tell us why this person/agency should receive an award:

Tell us why this person/agency should receive an award: *

Nominee Address: *

Thank you for your submission! Winners will be announced on or about November 19, 2020.

Submitter address

Upload File

We were unable to upload your file. Please ensure your file is 10MB or smaller in size.

Affirmation *

By checking this box, the submitter affirms he/she has given true and accurate information to the best of his/her knowledge and gives permission for VACA to contact the listed names.

Full name/title of nominee: *

Employed by / volunteers at: *

Date and time

Employed by: *

Submitter name: *

Affirmation: *

By checking this box, the submitter affirms he/she has given true and accurate information to the best of his/her knowledge and gives permission for VACA to contact the listed names.

Submitter name: *

Award Choice (choose one): *

Animal Control Officer of the Year

Valor

Public Service

Outstanding Agency

President

Submitter Address:

VACA 2022 Awards Nomination Form

Nomination Deadline: September 1, 2022

Award Choice: *

ACO of the Year

Valor

Public Service

Outstanding Agency

President

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