Application Due:  May 19th, 2017

* 1. Junior student being nominated:

* 2. Name of Nominating Person (can be any person with experience & knowledge of the student's service including the student him/herself):

* 3. Please briefly describe why the person meets the criteria outlined in the ShineOnCass Junior Service Award: ShineOnCass Service Award Description

* 4. Please list the organization(s) for which the student has volunteered and the service provided; including number of hours volunteered.

* 5. Please list a FIRST person of reference who may be contacted to provide additional information about the student.  Please list phone and e-mail contact.

* 6. Please list a SECOND person of reference who may be contacted to provide additional information about the student.  Please list phone and e-mail contact:

* 7. Please list any additional information below:

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