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Chase Youth Awards Nomination Form 2018-12-04T14:32:56+00:00

Chase Youth Awards Nominations

Please fill out the form below or click here for a nomination form.  Nominations due February 15, 2019.

If you have any questions, please contact Susan Nelson, Executive Director at (509) 822-7905 or chaseyouthspokane@gmail.com.

Nomination Form

Category

Please pick the category your nominee fits into:

*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.

Divisions

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:

Tell us about the Nominee(s), in 3000 characters:

  • Describe how you know the nominee and the length of your relationship.
  • Describe the nominee's activities and character. Include any special attributes or challenges that set this nominee apart.
  • Describe the impact this nominee has on other people and/or programs. Incude any information about how much time, energy, or skill is involved.
  • Describe the nominee's level of commitment or dedication.


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Information about the Nominee

Name of Individual/Group*:

Address:

City:

State:

Zip Code:

Phone Number:

Age(s):

Gender(s):

Grade(s):

School:

*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.

1.) Name:

Phone Number:

2.) Name:

Phone Number:

Information about the Nominator

Nominator's Name:

Nominator's Address:

Nominator's City:

Nominator's State:

Nominator's Zipcode:

Nominator's Phone Number:

Nominator's Email:

Nominator's Affiliation:

“Not only does the Commission give students vital and practical experience working on service projects, but it gives us the confidence to start and lead projects on our own.”

-Matt

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