Please fill out the form below or click here for a nomination form. Nominations due January 19, 2018.
If you have any questions, please contact Susan Lane, Executive Director at (509) 822-7905 or firstname.lastname@example.org.
Please pick the category your nominee fits into:
Arts & CreativityCommunity InvolvementCompassionCultural AwarenessInnovationLeadershipPersonal AchievementSocial AdvocacyJim Chase "Asset Builder" Adult Award*
*Individual must be at least 18 years of age and no longer enrolled in high school. Nominees are judged on their asset building efforts for Spokane County youth.
Any individual or group of youth attending grades K-12 or equivalent are eligible for nomination. Multi-age groups will be placed in the division of the oldest member. Emphasis is given to significant contributions made within the last 18 months in Spokane County.
Please pick the division your nominee fits into:
Individual Elementary (K-6)Individual Middle (7-8)Individual Teen (9-12)Elementary School GroupMiddle School GroupTeen Group
Tell us about the Nominee(s), in 3000 characters:
Information about the Nominee
Name of Individual/Group*:
*Group Nominations: List group members on separate lines. Receipt of this list generates the invitations and individual names in the program. We are unable to make changes to incorrectly submitted names.
References for Nomination Verification
Please do not list anyone less than 21 years of age as nomination verifiers. Examples of acceptable verifiers are: parent, teacher, counselor, principal, etc.
Information about the Nominator
Nominator's Phone Number: