Honoring the People Making a Rural Difference

Congratulations on your 2022 Community Star Nomination!

We ask that you accept your nomination by completing this questionnaire to verify information and details submitted about your work, as well as provide additional information about yourself, your organization, and your service in rural health.

Questions about the Community Star Recognition program? Visit our FAQ page.

Submit Your Community Star
Nominee Questionnaire

Before You Begin

Before you complete this online, automated form, you may want to download the questions you will be asked in advance to give you time to formulate your answers. ONCE YOU BEGIN FILLING OUT YOUR ONLINE QUESTIONNAIRE, YOU WILL NOT BE ABLE TO SAVE YOUR SESSION.
 
If you complete your questionnaire using the Word Document, you can simply copy and paste your answers accordingly in the online form when you are ready to begin. 

PLEASE VERIFY ALL SPELLING AND EMAIL ADDRESSES ARE CORRECT.

Upon submission, you will receive a PDF copy of your responses at the email address provided. If you do not receive a confirmation of your nomination, please check your spam folder.

*NOSORH would like to tag/mention your organization on our social media channels to promote your star profile on NRHD.

Have questions?

Visit the FAQs

We’ve put together some of the most commonly asked questions regarding the Community Star recognition program. If you have a question that’s not addressed in the FAQs, feel free to send us an inquiry via the contact form link in the footer.