46th GREATER WEST BLOOMFIELD
MICHIGAN WEEK COMMUNITY AWARDS BREAKFAST
May 18, 2018 - Glen Oaks Country Club, Farmington Hills - Honoree Registration: 7:00 AM

Dr. Seymour Gretchko Youth Advocate - Group Nomination Form

Please carefully review the information in both parts of this OVERVIEW and in EVENT LOGISTICS at the end of this document.

Because all information must be completed in a single session, consider printing this document for advance planning and preparation purposes before responding to the questions. Click on OK when completing each section.

Thank you in advance!

AWARD ELIGIBILITY CRITERIA:

The Dr. Seymour Gretchko Youth Advocate Award — GROUP honors one organization, institution, business, organized group or association which

1. Serves Greater West Bloomfield (Cities of Keego Harbor, Orchard Lake Village, Sylvan Lake and West Bloomfield Township) in a voluntary and/or professional capacity.
2. Demonstrates that advocacy and education of youth has played a significant role during the individual’s lifetime.
3. Models visionary leadership.
4. Contributes to building a more inclusive society.
5. Is recognized for his or her sustained impact upon the community.
6. Creates effective partnerships on behalf of youth.
7. Motivates others to strive for professional excellence.

* The nominee must be nominated by an Organization OR TWO PERSONS not related to the individual nominee.

* Previous award recipients are ineligible for the same category.

* This is a competitive recognition.

OVERVIEW, continued

KEY NOMINATOR RESPONSIBILITIES:
1. Answer each of the twelve questions in this nomination form. Responses are required to each question.
2. Click "DONE" after the last page to submit it. Provide additional follow up, if requested.
3. By March 2, 2018, email a digital photo of the organization to DebMacon4@gmail.com.
4. By May 4, 2018, purchase any Breakfast Registrations needed in addition to the one provided at no cost by the Awards Committee.

KEY GREATER WEST BLOOMFIELD MICHIGAN WEEK AWARD COMMITTEE RESPONSIBILITIES:
1. Confirm nomination is received, review eligibility and communicate award status to the nominator.
2. Awardees will be acknowledged in the printed awards program & their photos displayed when introduced at the Michigan Week Community Awards Breakfast on May 18.
3. Each awardee receives a special plaque and certificate of recognition.
4. Invite elected officials serving Greater West Bloomfield to CONGRATULATE awardees.
5. Facilitate recording and cablecasting of the Awards Breakfast Civic Center TV. The program will run on Comcast channel 15 and AT&T Channel 99, including OnDemand & on YouTube.
6. Respond to questions emailed to the Awards Committee Chair. DebMacon4@gmail.com
7. Finalize award decisions.

Question Title

* 1. What is the name of the group being nominated for the Dr. Seymour Gretchko Youth Advocate Award - Group and what is their contact information?

Name *

Title

Organization/Business *

Address

City/Town *

ZIP Code *

Email Address *

Cell or Home Phone Number *

Question Title

* 2. Who is the 1st Nominator or Organization Representative submitting this nomination and what is their contact information?

Name *

Title *

Organization

Address *

City/Town

ZIP Code *

Email Address *

Cell or Home Phone Number *

Question Title

* 3. Who is the 2nd Nominator submitting this nomination and what is their contact information?

Name *

Title *

Organization

Address *

City/Town

ZIP Code *

Email Address *

Cell or Home Phone Number *

Question Title

* 4. In what roles - professional and/or voluntary - does the nominee serve in Greater West Bloomfield?
Limit response to no more than 200 words.

Question Title

* 5. How does the nominee demonstrate that advocacy and education of youth have played a significant role during the individual's lifetime?
Limit response to no more than 200 words.

Question Title

* 6. How does the nominee model visionary leadership? How does the nominee contribute to building a more inclusive society?
Limit response to no more than 200 words.

Question Title

* 7. In what ways is the nominee recognized for having a sustained impact upon the community? How does the nominee create effective partnerships on behalf of youth?
Limit response to no more than 200 words.

Question Title

* 8. How does the nominee motivate others to strive for professional excellence?
Limit response to no more than 200 words.

Question Title

* 9. A digital photo:

Has been emailed to DebMacon4@gmail.com

Will be emailed to DebMacon4@gmail.com on or before March 2, 2018

Question Title

* 10. This nomination is submitted prior to 5:00 PM, March 2, 2018.

YES

Question Title

* 11. If this nominee is selected by the Awards Committee to receive the Dr. Seymour Gretchko Youth Advocate - Group, the Nominator listed in #2 above will be contacted. One representative of the honoree group will receive a complimentary registration to attend the Michigan Week Community Awards Breakfast on Friday, May 18, 2018. This person must arrive by 7:00 AM to register. A hot buffet breakfast will be served at 7:15 AM.

Use the "Registration Here" link at www.michiganweek.org to register additional attendees.

Who will accompany the honoree on May 18th?

First Name *

Last Name

Title *

Email Address *

Cell or Home Phone Number *

Question Title

* 12. All facts, dates and spelling of names for publication, have been carefully checked.

YES

Thank you for helping to honor those who make a difference in the quality of life in Greater West Bloomfield and Michigan.

Your dedication to appreciating those who freely share their time, talents and support helps strengthen Greater West Bloomfield and Michigan families, neighborhoods, organizations and communities!

At your service and in appreciation,
46th Greater West Bloomfield Michigan Week Awards Committee

EVENT LOGISTICS

46th GREATER WEST BLOOMFIELD MICHIGAN WEEK COMMUNITY AWARDS BREAKFAST
Friday, May 18, 2018
Glen Oaks Country Club, 30500 West 13 Mile Road, Farmington Hills 48334
ADVANCE REGISTRATION IS REQUIRED. NO REGISTRATIONS WILL BE ACCEPTED AFTER MAY 4 OR ON MAY 18
Honoree Registration: 7:00 AM, Friday, May 18
Buffet Breakfast: 7:15 AM, Friday, May 18

2018 Program Theme: "Honoring Our Public Safety Departments"

Additional information is available at www.michiganweek.org
* Register by credit card.
At www.michiganweek.org, click on "Register Here" to access PayPal.
* Register by mail with a check.
Make the check payable to West Bloomfield Youth Assistance - Michigan Week's fiduciary agent. Mail or drop off the check at the Greater West Bloomfield Cable Communications Commission during weekday business hours at 4510 Walnut Lake Road, West Bloomfield, MI 48323. The Greater West Bloomfield Cable Communications Commission is a Michigan Week partner.

Michigan Week Awards Calendar
* February 2 to May 4, 2018 * Register to attend the Breakfast
* On or before March 2, 2018 * Nomination Forms are due
* On or before March 2 , 2018 * Email digital photo of nominees to DebMacon4@gmail.com
* April 2 to April 6 * Awards Committee announces honorees
* May 18, 2018 * Attend the 46th Greater West Bloomfield Michigan Week Community Awards Breakfast

Question Title

* 1. What is the name of the group being nominated for the Dr. Seymour Gretchko Youth Advocate Award - Group and what is their contact information?

Question Title

* 2. Who is the 1st Nominator or Organization Representative submitting this nomination and what is their contact information?

Question Title

* 3. Who is the 2nd Nominator submitting this nomination and what is their contact information?

Question Title

* 4. In what roles - professional and/or voluntary - does the nominee serve in Greater West Bloomfield?Limit response to no more than 200 words.

Question Title

* 5. How does the nominee demonstrate that advocacy and education of youth have played a significant role during the individual's lifetime?Limit response to no more than 200 words.

Question Title

* 6. How does the nominee model visionary leadership? How does the nominee contribute to building a more inclusive society?Limit response to no more than 200 words.

Question Title

* 7. In what ways is the nominee recognized for having a sustained impact upon the community? How does the nominee create effective partnerships on behalf of youth?Limit response to no more than 200 words.

Question Title

* 8. How does the nominee motivate others to strive for professional excellence?Limit response to no more than 200 words.

Question Title

* 9. A digital photo:

Question Title

* 10. This nomination is submitted prior to 5:00 PM, March 2, 2018.

Question Title

Question Title

* 12. All facts, dates and spelling of names for publication, have been carefully checked.

* 4. In what roles - professional and/or voluntary - does the nominee serve in Greater West Bloomfield?
Limit response to no more than 200 words.

* 5. How does the nominee demonstrate that advocacy and education of youth have played a significant role during the individual's lifetime?
Limit response to no more than 200 words.

* 6. How does the nominee model visionary leadership? How does the nominee contribute to building a more inclusive society?
Limit response to no more than 200 words.

* 7. In what ways is the nominee recognized for having a sustained impact upon the community? How does the nominee create effective partnerships on behalf of youth?
Limit response to no more than 200 words.

* 8. How does the nominee motivate others to strive for professional excellence?
Limit response to no more than 200 words.