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NRTA With Our Youth! Nomination Form

Please read the With Our Youth! nomination guidelines before completing the form. Please complete the online form by June 8, 2010.

If you do not receive a confirmation receipt via email within three business days, please call NRTA at (202) 434-2380.

NOMINEE INFORMATION

*Contact Name:

Organization:

*Address:

*City, State, ZIP:

*Contact Phone:

*Contact E-mail:

NOMINATOR INFORMATION

*Nominator Name:

Organization:

*Nominator Address:

*City, State, Postal Code:

*Nominator Phone:

*Nominator E-mail:

PROJECT DETAILS

*Type of Project:

StateLocalIndividual

*Brief description of the project

Describe in 100-200 words the impact of the project on the youth with whom the volunteer(s) worked. If applicable, please also describe the impact on others in the community resulting from the project.

*Description of project impact

Submit Application

Fields marked with a * are required.

Nomination Timeline

Nominations may be sent at any time through the calendar year. An independent selection committee will meet to select the annual award recipients from those nominations received by June 8, 2010. All submissions received thereafter will be considered for the next round of awards.

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