Advocate of the Year Nomination Form

2025 Michael Askew Recovery Advocate of the Year Nomination Form

Nominations will be accepted through January 17th, 2025. All nominees must live in Connecticut.

Your Name *

First

Last

Email *

Phone *

Nominee's Contact Info *

First

Last

Nominee's Email

Nominees Title & Organization

Does this person know they've been nominated? *

In 500 words or less, tell us why you nominated this individual for the Michael Askew Recovery Advocate of the Year Award? *

Get In Touch

p| 866-205-9770
f| 860-244-2228

75 Charter Oak Ave
Building 1, Suite 305
Hartford, CT 06106

Scroll to Top