2019 Young Heroes Application
Please be prepared to answer the following questions:
• Nominee’s name and contact info
• Nominee’s grade level
• Nominee’s relationship to Rotary/Rotary members (if any) and/or LPB/LPB staff (if any)
• Parent/Guardian’s name and contact info
• Nominator’s name and contact info
• Nominator’s relationship to nominee
• Are you a member of Rotary? Which chapter?
• About the nominee:
o Snapshot (brief description/personal background)
o Community Involvement
o Examples of Leadership
o Academic Involvement & Achievement
o Perseverance
o Additional Info (you may upload a maximum of 5 documents)
Email address *
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