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AWARDS - The Young American Award |
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Local Council Deadline:
December 1
Council Young American Award Application Nomination of (full name) ______________________________________
Name by which he or she is know, if different ________________________
Street address __________________________________________________
PO Box _______________________________________________________
City______________________ State________________ Zip _____________
Home telephone (____) ____________________
Age next June 1 _______________________ Date of birth ______________
Father's name ___________________ Work phone (___)______________
Mother's name ___________________ Work phone (___)______________
Guardian's name __________________ Work phone (___)______________
Nominee's Personal Record (attach additional sheets if needed):
Current Organizations List school and community organizations in which the nominee is now active and involved in service that adds to the quality of life
Past Organizations List school and community organizations in which the nominee was involved in the past and involved in service that added to the quality of life
Leadership List all leadership positions that the nominee has ever held. Indicate with an asterisk those positions currently held
Recognitions List important achievements, awards, or recognitions received by the nominee, the organizations that presented them; and the year they were received
Name of Recognition Presenting Organization Year Received
Current High School Record
______Freshman ______Sophomore ______Junior ______Senior
Graduating class year ______________ High school name ________________
Current grade point average __________ Current class rank ______________
Current College or University Record
______Freshman ______Sophomore ______Junior ______Senior ______Graduate School
School name_________________________ City _____________________ State _____
Graduating class year ___________________ Current grade point average ___________
Current class rank ________________________________________
Present Career Plans Nominee's present career plans:
Statement of Accomplishments Describe the nominee's outstanding accomplishments in the fields of art, athletics, business, community service, education, government, humanities, literature, music, religion, or science.
Nominating Organization
Name of organization submitting nomination ____________________________ By: Name ______________________ Title _____________________________ Street address _____________________________________________________
City _____________________________ State _____________ Zip __________
Work phone (____) _______________ Home phone (____) ________________
Submitted to (local council) no. ________________
Council name ______________________________ Council's Stamp Council executive's name________________ |
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