Download Printable Nomination Form
Muskingum County “Celebrate Youth Service” Awards
Youth Nomination Form
Youth/Youth Group Nominee Information:
Nominee’s Name:_________________________________________________ Age (as of 6/1/03):______________
Address:__________________________________________________ Birthdate:_____________________
__________________________________________________ School:_______________________
E-Mail:__________________________________ Telephone:____________________________
How long has the nominee been involved in this volunteer youth service activity?______________________________
Person Making the Nomination:
Nominator’s Name:___________________________________________ Telephone: (W)___________________
Address: ____________________________________________ (H)___________________
____________________________________________ E-Mail:__________________________________
Relationship to Nominee: (parent, friend, teacher, clergy) __________________________________
THE NOMINATION:
Please answer the following questions that apply to your Nominee. Please provide specific and detailed examples that support
the particular area for which the nomination is made. Please type or print. You may attach additional pages as necessary.
1. Please describe the reason you are nominating this youth/youth group.
Why is the nominee particularly deserving of this recognition for his/her/their volunteer work?
2. How have the actions of this young person/youth group benefited and impacted others?
3. Were there any obstacles the young person/youth group had to overcome?
4. If nominee is an individual, did this young person act alone? Was s/he part of a group? Please explain.
5. Comment on the nominee in terms of their COURAGE, COMPASSION and/or COMMUNITY/SCHOOL SERVICE.
Nominations for the Muskingum County “Celebrate Youth Service” Awards are based on COURAGE, COMPASSION, and/or SERVICE. Definitions of these categories are left to the nominators, however, these general comments may be helpful:
COURAGE entails overcoming an obstacle in order to help others. Courage may be interpreted in a rescue, an act of bravery or heroism, overcoming a personal challenge, etc. It is understood there are many forms of courage, but these acts of courage must benefit others as well as self.
COMPASSION comprises both the understanding of peoples’ problems and needs and extending help to address these problems and needs.
SERVICE is applying effort and time to others for a special project for no apparent personal gain.
Download Printable Nomination Form
Please complete the Nomination Form and mail, fax, or e-mail the Nomination Form & any attachments to:
PRO-Muskingum, P.O. Box 2475, Zanesville, OH 43702-2475
Fax: 740-454-7993 or E-Mail: kathymcleish@pro-muskingum.org
