North Valley CTC Youth Recognition Award Nomination Form

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The North Valley Communities That Care coalition wants to recognize the youth in our community for positive behaviors such as outstanding achievements, acts of kindness, service, or involvement in the community. Please answer the questions below to nominate a youth (age 10-18) from the Stansbury, Erda, or Lake Point communities.
If you have questions, please contact Jared Hall at jared.hall@tooeleco.gov or 435-277-2479.

Your Name *

Would you like to be left anonymous? (If so, your information will only be used by the coordinator to prepare the award. *

Yes

No preference

Your Contact Information (phone and/or email) *

Name of youth (aged 10-18) you are nominating: *

What grade is the youth you are nominating (if known):

Current Month and Year *

Select youth's place of residence: *

Stansbury Park

Erda

Lake Point

Select the category that best describes the reason for nomination: *

Please tell us more about why you are nominating them: *

Youth's parent/guardian name (if known):

Youth's parent/guardian contact info (if available):

Your connection with the nominee: *

Comments:

Submit

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