YOUTH NOMINATION FORM

UPLIFT BY YOUTH ERA

We welcome nominations from parents, teachers, counselors and other adults who feel a particular youth is deserving of a scholarship to attend Uplift.

NOMINATION FORM

Nominator's Name

First Name

Last Name

Name of Youth

First Name

Last Name

Nominator's Email

Youth's Email

(Non- school email address if possible, please)

Nominator's Phone

(###)

###

####

How old will the youth you are nominating be in 2022?

City in which Youth resides

State in which Youth resides

School youth attends

How would this youth benefit from Uplift? Why would this youth make an outstanding addition to our Uplift scholarship recipients?

You can copy and paste several paragraphs into this field

Youth's Phone Number (if you have it)

(###)

###

####

YOUTH NOMINATION FORM

UPLIFT BY YOUTH ERA

NOMINATION FORM

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