Home / Ashby Award Nomination

B.R. Ashby, M.D. Award for Outstanding Community Service Nomination Form

Nominations are due Friday, September 6, 2024.
If you have questions, please contact Reggie Singletary, Senior Program Officer at 434-799-2176.

Please attach your response to the question below in the field provided at the end of the form.
Limit your response to three (3) typed, double-spaced pages, using a 12-point font with 1-inch page margins.

Why do you think this organization deserves the Danville Regional Foundation's B. R. Ashby, M. D. Award for Outstanding Community Service?

Be sure to include information about:

How the organization has improved the quality of life of residents in the Region.
How the organization has demonstrated a commitment to caring and generosity of spirit.

Fields marked with an (*) are required and cannot be left blank

About the Nominee

Name of Nominated Organization *

Nominee Address *

Nominee Phone *

Nominee City *

Nominee State *

Nominee Zip *

Chief Executive Officer *

Nominee Email *

About the Nominator

Affiliation with Nominated Organization *

Nominator's Name *

Nominator's Email *

Nominator's Address *

Nominator's City *

Nominator's State *

Nominator's Zip Code *

Answer Document File Attachment (Word or PDF files only) *