Organization's recommendation of Parent/Family Leader for FRIENDS PAC

This form is filled out by the staff person (CBCAP State Lead Agency or representative of Tribe, Tribal organizations, Migrant program, or community-based family strengthening/child abuse prevention program) recommending a parent/family leader nominee to the FRIENDS National Center for CBCAP Parent Advisory Council

The Organization’s Recommendation must accompany a Parent/Family Leader Self-Nomination form (completed separately by the parent/family leader located at https://friendsnrc.org/friends-pac-parent-nomination/). Both forms may be submitted electronically between October 1 and October 31, 2025 or filling out the 2025 Organizational Nomination for FRIENDS PAC and emailing it to MaryJo Alimena Caruso of FRIENDS NC for CBCAP at mjcaruso@friendsnrc.org.

All nomination materials must be received by 10/31/25.

1. Organization Information:

Name of Organization providing the parent/family leader recommendation:

Name and Title of person completing the recommendation:

Mailing Address of the Organization:

City

State

Zip Code

Phone Number(s) for Organization Contact

Email

Are you the CBCAP State Lead Agency?

Yes No

If no, are you a staff representative of a Tribe, Tribal organization, Migrant program, or community-based service provider?

Yes No (if no, please specify primary agency role below)

Primary Agency Role (if not CBCAP State Lead Agency, Tribe, Tribal organization, Migrant program, or community-based service provider)

To view the map of current FRIENDS PAC members, please see https://friendsnrc.org/parent-advisory-council/.

Is your state currently represented by a parent leader on the FRIENDS PAC?

Yes No, Never No, Not Currently

2. Parent/Family Leader Nominee Information:

Name of Nominee

Nominee Home/Mailing Address

City

State

Zip Code

Phone Number(s):

Email

3. What is your relationship to the parent/family leader?

4. Why is this parent/family leader a strong candidate for the FRIENDS National Center for CBCAP Parent Advisory Council?

5. In what areas does the parent/family leader have knowledge or experience related to one or more of the purposes or requirements of the CBCAP program:

Participating in activities and services that support families and prevent child abuse and neglect Receiving services and resources to support my family (e.g., voluntary home visiting, respite services, etc.) Receiving support for needs of families with children with disabilities (e.g., respite care) Providing leadership in the planning, implementation, and evaluation of prevention programs and policy decisions Promoting public information in their community or state to increase awareness on child abuse and neglect prevention Contributing TTA activities for child abuse prevention programs Other (please specify below)

Please specify (if applicable):

6. How has this parent/family leader served in a leadership capacity in your organization or state? For example, what roles have they held? How have they served as a change agent for family strengthening and child abuse prevention?

7. Describe any community, faith, school, or other organizational activities the parent/family leader been involved in:

8. How have you observed this parent/family leader speaking to large groups, serving as a co-trainer, or working with the media? Please describe.

9. This is an opportunity for a parent/family leader to represent your state. How will this parent/family leader be able to fulfill the Council responsibilities for a 3-year term either independently or with the support of your organization? Please explain. Please review the expectations and requirements of PAC candidates listed in the 2025 Call for Nominations.

10. What else would you like to share with FRIENDS NC for CBCAP about this parent/family leader?

Organization Recommendations will only be considered complete upon receipt of the candidate’s Parent/Family Leader Self-Nomination form.

Materials will be accepted thru 10/31/25. All requests for an extension must be submitted in writing to mjcaruso@friendsnrc.org prior to 10/31/25 for consideration.

Organization's recommendation of Parent/Family Leader for FRIENDS PAC

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