2021 Appreciation Award Nomination Form

Question Title

* 1. Nominee's Information:

Name

Title

Organization

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Award Category:

Parent Volunteer of the Year

Business Donor of the Year

Youth Serving Organization Partner of the Year

UYLC Member Volunteer of the Year

Government Partner of the Year

Outstanding Youth Member of the Year

I do not know what category this prevention advocate fits into

Education Partner of the Year

Religious Organization Partner of the Year

Media Partner of the Year

Law Enforcement Partners of the Year

Healthcare Partner of the Year

Civic Group Partner of the Year

Other (please specify)

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* 3. Please describe the nominee’s contributions to the UYLC mission and why you believe they deserve to be recognized:

Question Title

* 4. Nominator's Information:

Name

Title

Organization

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number