*1.Nominator's Information (this is you)*(Required.)

First Name

Last Name

Job Title

Organization/Company Name

Email Address

Phone Number

*2.Nominee's Information (person you are nominating for the award)*(Required.)

First Name

Last Name

Job Title

Organization/Company Name

Email Address

Phone Number

*3.Select the category for the person you are nominating.(Required.)

Safety & Belonging: Creating Safe and Inclusive Spaces for Youth

Supportive & Responsive School Conditions: Centering Student Voice in Decision Making that Affects Daily School Conditions

Affordability for All: Reducing the Burden of Basic Needs Through Partnerships

*4.Why  have you selected this individual for this category? Briefly describe the nominee’s community involvement, volunteer activities, impact on children, youth and families in the City of Alexandria.(Required.)

*5.Describe how the nominee has made the community a better place for children, youth and families in Alexandria, including any programs, projects or other efforts that impact children and youth.*(Required.)

*6.Provide a biography of nominee (100 words or less)*(Required.)

7.Optional: Additional comments that you deem relevant to the nominee’s application, such
as, but not limited to past awards, membership on boards and commissions, etc. Nominators
may also provide website links to stories and materials that show how compelling the
nominee’s story and work is in the community