MLKCC Dr. King Youth Trailblazer Award Nomination Form

MLKCC Dr. King Youth Trailblazer Award

Official Nomination Form
The Dr. Martin Luther King Jr. Celebration Committee is in search of outstanding students to award for the annual Youth Trailblazer Award. We will recognize students who have made a significant positive change in their life/church/community/school/ etc.

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****SUBMISSION Deadline Tuesday, January 14th, 2025****

NOMINATION DEADLINE: Tuesday, Jan. 14th, 2025

Winners will be honored during the Dr. Martin Luther King Celebration Parade/ Multi-Cultural Unity Show. Monday, January 20th, 2025
NOMINATED INDIVIDUAL
Full Name of Nominee*

First NameLast Name
Date of Birth *

MonthDayYear
Cell Phone Number *

Area CodePhone Number
E-mail *
example@example.com
School
Weighted Grade Point Average *
Tell Us About Your Student? How have they made a significant positive change in their life or church/community/school/ etc. Please also include your students career/job interest if applicable. Pictures and videos are encouraged, not required!
Work History
Awards and Recognition (if applicable/not mandatory)
Please list what college (s) you have been accepted to:
1. Upload Pictures/Videos

Upload a File

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2. Supporting Documents

Upload a File

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NOMINATOR INFORMATION
Name of Nominator*
E-mail*
example@example.com
Phone Number *

Area CodePhone Number
Relationship to Nominee
REASON FOR NOMINATION
List merits and reasons for nomination
Signature of Applicant

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REGISTRATION POLICY

You are submitting a request to nominate an individual who has demonstrated the values of Dr. Martin Luther King Jr. Nominees must expressed the following traits: Compassion towards others, Proven Leadership, Treating others with Dignity& Respect, Code of Ethics, Integrity, Selfless Acts of Kindness and Dedicated towards a cause.
All nomination forms are strictly confidential and if approved an official notification letter will be sent from our office.
Name of Parent if under 18 years old

First NameLast Name
Signature of Parent

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How did you learn about Youth Trailblazer Award
Contact 754.235.3298, projectteach04@gmail.com kingholidaycelebration@gmail.com

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