Membership Registration

2012 SAVE Awards Application

This form should be completed for each presentation for each group. Applications are due by January 15, 2012.
Primary Adviosr/Teacher

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
I will be the one responsible for coordinating the youth groups activities including transportation, meeting deadlines and teaching violence prevention lessons
A secondary Advisor/Teacher is not required buy highly recommended.
Secondary Adviosr/Teacher

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Organization or School Information
Name of Organization or School
Name of youth program or group that is applying.
Address of Orgnization or School that is host to the youth group

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of the Director or Principal of the above organization

First NameLast Name
The type of artistic presentation that the youth groups will be presenting?
Will the presentation be original work created by the youth?
How many youth are in the group and expected to take part in the creation of the presentation?
What are the ages of the youth that will be participatin in the SAVE Awards?
Briefly describe the purpose or function of your group of youth.
How often will your youth group be meeting on a weekly basis to work on the presentation for the SAVE Awards?
What type of violence will your youth group be addressing?
I acknowledge that I have read the 2012 SAVE Awards Guidelines. As Group Advisor, I will be directly responsible for the coordinating of group activities. I understand and will comply with all guidelines. My compliance with the program dates and guidelines are necessary for my youth’s participation in the SAVE Awards program. I understand that not adhering to these guidelines can terminate my group’s participation in this program.
If you chose "other" for any of the questions below please describe it further here.
Should be Empty:

2012 SAVE Awards Application

A secondary Advisor/Teacher is not required buy highly recommended.