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 2017

Child Protection & Domestic Violence Prevention

On December 14, End Abuse Long Beach will honor two Long Beach community members for their outstanding contributing/volunteering in the prevention/treatment of domestic violence, child abuse, sexual assault, and elder abuse.
To make a nomination, please complete as follows:

Your Nominee:



      

Your Information:



   

Deadline for submissions to be considered: September 14, 2017

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

SIGNATURE: ___________________________ DATE: _________________