DISTINGUISHED GIFTED TEEN AWARD APPLICATION
The purpose of this award is to recognize a student currently between the ages of 12 to 17 who has demonstrated giftedness, dedication, creativity, and a desire to help others. Students may self-nominate or be nominated by another individual. A $500 check will be awarded to the winner at the Awards' Ceremony.

Procedure:
The nominator must be a current member of GAGC.

The nomination packet must include:
1) Completed nomination form (next page)
2) One letter of recommendation from a teacher or principal who is not a family member of the student. The letter should
explain why the student is deserving of the award, what sets him or her apart from others, and how the nominee is
impacting others. (Maximum of two pages.)
3) One letter of recommendation from a community or civic leader who is not a family member of the student. The letter
should explain why the student is deserving of the award, what sets him or her apart from others, and how the nominee is
impacting others. (Maximum of two pages.)
4) 750-word composition written by the student that responds to each of the following questions:
a) What is the activity or interest area for which the student is being nominated?
b) How did the student become interested/involved in the activity?
c) What impact has the activity had on the student and on others?
d) How have the student's future plans and goals been affected by this activity or interest area?
5) A Release Form completed and signed by a parent or guardian

Recognition:
The award recipient will be acknowledged with a plaque presented at the annual convention, a certificate of recognition from the GAGC President, and $500 spent on a Savings Bond.

Nominations shall be completed online and submitted by December 14, 2018. Additional supporting documentation should be submitted via email to awardschair@gagc.org by December 14, 2018.

Name of Nominee: *
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Nominee Home Address: *
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Nominee City, State, Zip Code: *
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Nominee Age: *
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Nominee Birth Date: *
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Nominee's Grade at time of Nomination *
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Name of Nominee Parent or Guardian *
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Nominee Parent/Guardian’s Home Address: *
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Parent/Guardian’s City, State, Zip Code: *
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Nominee Parent or Guardian E-mail: *
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Nominee Parent or Guardian's Daytime Phone: *
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Nominee Parent or Guardian's Evening Phone: *
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Nominee School: *
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Nominee’s School Address: *
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Nominee’s School City, State, Zip Code: *
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Name of Nominator: *
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Nominator Home Address: *
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Nominator City, State, Zip Code: *
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Nominator E-mail: *
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Nominator Daytime Phone: *
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Nominator Evening Phone: *
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Nominator GAGC Membership Status: *
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Letter of Support *
Please type a letter to the committee in the space below explaining your reasons for the nomination. (No more than two typed pages please)
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