2025 - 2026 LifeChanger of the Year Certificate Request

Please fill out this form to request a physical, mailed LifeChanger of the Year certificate for a current nominee. Any questions? Feel free to get in touch here.

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1. Please choose the statement that best applies: (Required.)

I am a LifeChanger nominee requesting my own certificate

I am an administrator/district employee requesting my nominee's certificate

Other (please specify)

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2. If you are requesting a certificate on behalf of a nominee, please leave their name here:

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3. What is your full name? (Required.)

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4. If you have any edits to the name on the original PDF certificate, please put them below.

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5. Please enter the address you'd like us to use for mailing. (Note: for nominees requesting personal certificates, we highly recommend using a personal address to prevent the certificate from getting lost.) (Required.)

Address 1

Address 2

City

State

Zip Code

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6. What type of address is this? (Required.)

School/district address

Personal address

Other (please specify)

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* 1. Please choose the statement that best applies: (Required.)

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* 2. If you are requesting a certificate on behalf of a nominee, please leave their name here:

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* 3. What is your full name? (Required.)

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* 4. If you have any edits to the name on the original PDF certificate, please put them below.

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* 5. Please enter the address you'd like us to use for mailing. (Note: for nominees requesting personal certificates, we highly recommend using a personal address to prevent the certificate from getting lost.) (Required.)

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* 6. What type of address is this? (Required.)

1. Please choose the statement that best applies: (Required.)

2. If you are requesting a certificate on behalf of a nominee, please leave their name here:

3. What is your full name? (Required.)

4. If you have any edits to the name on the original PDF certificate, please put them below.

5. Please enter the address you'd like us to use for mailing. (Note: for nominees requesting personal certificates, we highly recommend using a personal address to prevent the certificate from getting lost.) (Required.)

6. What type of address is this? (Required.)