Lisa Moore RedBone Press

C.C. Carter Poet, Writer and Activist

Pat Baillie Albuquerque Pride, Inc.

Brian Brown New Mexico AIDS Services

Joy Silver RainbowVision Properties

Alison Bock Activist and Humanitarian

Vincent R. Johnson Models of Hope Nomination Form We are looking for individuals that not only the GLBT youth can look up to, but anyone the community can see as a ray of light for how the community should be portrayed. If you know someone who should be on this list, please complete this form. The person(s) chosen will appear in the January-February issue of Pride & Equality magazine and be the guest of honor at the first annual Model of Hope Awards Dinner at Sandia Resort in Albuquerque, New Mexcio. All entries must be received by September 1, 2009. *Full name of nominee: *Occupation: *Address: *City: *State: Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Country: *Zip: *Phone Number (for verification only): *Email: *Full name of person nominating the nominee: *Address: *City: *State: Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Zip: *Phone Number (for verification only): *Email: *Why do you feel this person is a Model of Hope for the GLBT community? (If there is additional material to support this nomination, please fax to (505) 212-0658). *Enter the code you see in the image: Can't read the letters? Get a new image If any information is incorrect or not filled out, or if the nominee refuses to be selected, nomination will become null and void. So please make your nomination count!

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