Adult Advisor YLA Nomination Form

To be filled out by an adult advisor 

Due by 11:59pm EST on Wednesday March 1, 2023

Thank you for taking the time to share your perspective on this young person with us!  We are awarding the Youth Leadership Awards for The 84 Movement to a youth for their outstanding tobacco prevention leadership in their communities and/or statewide.  
 
  • Please remember that your recommendation is very important in the applicant’s application process. 
  • Please let us know if the nominee has overcome any particular hardships (i.e. navigating English-speaking spaces with English as a second language). 
  • Keep in mind that the youth also needs to nominate themselves. Feel free to work them on the essay questions that they will be submitting online.
  • Statewide Leadership Team members are NOT eligible for this award.
 
For further questions and more information, feel free to contact Amanda Irizarry at airizarry@hria.org 

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* 1. Your name:

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* 2. Youth nominee’s name:

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* 3. How long have you known this young person and in what capacity?

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* 4. Please describe a significant achievement that this young person accomplished that bettered their community and/or state.

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* 5. What challenges arose for your Chapter and/or this young person in the last few years? How did the nominee work to overcome them?

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* 6. Do you have any other comments you would like to provide about their leadership skills and experience?

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