August 2, 2014

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Fair

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Conditions at Topeka, Philip Billard Municipal Airport, KS

YMCA Character Award Nomination Form

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The purpose of this award is to recognize those who have taken the time to improve the lives of others, have demonstrated a commitment to strengthening their community, and exemplify the core values taught by the YMCA. The Character Award winner will provide an example of a positive role model for others through this recognition of youth and adults. The character winner must demonstrate the YWCA core values - Caring, Honesty, Respect, and Responsibility.

Honorees will be selected in the following categories: Youth Civic Organization, Youth Church, Youth School, David Franzke Youth of the Year, and YMCA Staff. Honorees will receive a recognition plaque, their photo displayed in branch lobbies, and a $100 donation will be made in their name to the organization of their choice.

To nominate an Honoree, please complete the following...

1.Name of honoree
*
2.Honoree's phone number
*
3.Honoree's address
Street Line 1*
Street Line 2
City*
State / Province*
Country*
Zip / Postal Code
4.Category of Nomination*
Youth Civic Organization
Youth Church
Youth School
David Franzke Youth of the Year
YMCA Staff
5.Cite examples of how the nominee has consistently demonstrated one or more of the YMCA's Core values... Caring, Honesty, Respect, or Responsibility*
6.Cite one example of how the nominee has demonstrated outstanding charater*
7.How has the nominee positively impacted the community and acted as a role model for others through demonstrating one or more of the YMCA's Core values... Caring, Honesty, Respect, or Responsibility*
8.Information about the person submitting the nomination
First Name* M.I. Last Name*

Email Address* Daytime Phone* Evening Phone*
9.Relationship to the nominee
*
10.Please enter your date of birth.
Month* Day* Year*
11.Terms and Conditions
   YES, I have read, understand, and agree to the Web site usage agreement and privacy policy.
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