Confirmation For Your 2025 Community Service Award

Congratulations again on winning a 2025 Community Service Award from the AHNS Cancer Prevention Service! The Service members were impressed with your project proposal and are pleased to present you with the $1,000 award.

If you wish to accept this award, please complete the Confirmation form below and we will process your payment right away.

PLEASE NOTE: At the completion of your project, you will be requested to submit a brief report in which you should 1) summarize how the grant funds were utilized, and 2) provide an evaluation as well as the results of the project. We will publish this on the AHNS website and in the AHNS Blog, so if you have any photos or media from the event, please be sure to include that too. For further details on this report, please contact AHNS Associate Executive Director JJ Jackman.

2025 CPS CSA Recipient Form

Primary Award Recipient Name(Required)

First Last

Primary Award Recipient Email Address(Required)

Title of Your Entry(Required)

What is the date of your event?

Award Acceptance(Required)

I wish to accept the AHNS 2025 Community Service Award.

I wish to decline this AHNS 2025 Community Service Award

Make Check Payable To: (IMPORTANT: Your check needs to be made out to an institution and not an individual. Please also include a contact name at the institution that the check should be forwarded to):(Required)

Institution Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Any Special Instructions (i.e., please mail check with copy of award letter)?

Name

This field is for validation purposes and should be left unchanged.

2025 CPS CSA Recipient Form

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