MOTHERS AGAINST DRUNK DRIVING ‘TAKE THE WHEEL’ 2023 RECOGNITION AWARDS ENFORCEMENT HERO NOMINATION FORM (PLEASE TYPE)
Enforcement Hero - Given to a law enforcement officer who has established most DWI arrests within their department.
Your Name (including rank): Your Organization: Your Street Address: Your City/State/Zip Code:
Your Daytime Phone: Your Email Address:
Nominee Name (including rank): Nominee Organization: Nominee Address: Nominee City/State/Zip Code:
Nominee Daytime Phone: Nominee Email Address:
REASON FOR NOMINATION:
Completed nomination forms must be emailed NO LATER THAN – April 3, 2023 to: Emma Dugas – State Program Manager, MADD North Texas emma.dugas@madd.org
Please call 214.637.0372 x 4828 if you have questions.
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