Angel Award Nomination Form

Fill out the form below to nominate someone for the Angel Award. Nominations for the 2014 Angel Award will be accepted until midnight CST Friday, April 4, 2014.

Before you start, be sure to read over the rules and requirements to make sure your angel qualifies.

Here are some other tips:

  • You can send us additional information that shows your angel’s good works, such as newspaper clippings, photographs, letters of support, videotapes, DVDs, etc.
  • We can't return this information, so make a copy for your records.
  • Be sure to label any supplemental materials with your nominee’s name as well as your name.
  • You can choose to send us your nomination and any supplemental materials by mail to:
    The Angel Award
    P. O. Box 98029
    Baton Rouge, Louisiana 70898-9029
If you still have questions, call our Angel Award info line at 1.888.219.BLUE (2583) or e-mail us at angel.award@bcbsla.com.

 

Nominated By
* indicates required field
First Name
*
Last Name
*
 
Address
*
Include apartment, suite number, or PO Box, if applicable.
 
City
*
State
*
Zip Code
*
 
Phone Number
*
Fax Number

 
E-mail Address
*
Confirm E-mail Address
*
 
Relationship to Nominee

Nominee Information
First Name
*
Last Name
*
 
Address
*
Include apartment, suite number, or PO Box, if applicable.
 
City
*
State
*
Zip Code
*
 
Phone Number
*
Fax Number

 
E-mail Address
*
Confirm E-mail Address
*
 
Date of Birth
 
Nominee's Chosen Charity

Nomination Detail
What does the nominee do to serve Louisiana children?
*
 
Did the nominee initiate new programs or activities and use new methods to solve problems?
*
 
Has the activity or service provided by the nominee produced positive changes and provided examples for other groups?
*
 
What results has the nominee produced?
*
 
What amount of time does the nominee devote to the activity or service?
*
 
Was the nominee active, not a figurehead?
*
 
Has the nominee overcome unusual challenges, such as limited resources, public perceptions of the problem or a personal disability?
*