Champions of Hope Nomination Form 2025-2026
Thank you for your interest in nominating a future Champion of Hope! Your nominee will join up to 60 other young men in 11th or 12th grade in a unique leadership, philanthropy and service program hosted by The Centers for Youth and Families.
Champion of Hope Nominee
*
First Name
Last Name
Address of Nominee
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
High School of Nominee
*
Grade of Nominee
*
11th Grade
12th Grade
Nominee Guardian One
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First Name
Last Name
Guardian One Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Guardian One Phone Number
*
Please enter a valid phone number.
Guardian Two Email
*
example@example.com
Guardian Two
*
First Name
Last Name
Guardian Two Adress
Same as Above
Guardian Two Address (Different than Above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Guardian Two Phone Number
*
Please enter a valid phone number.
Guardian Two Email
*
example@example.com
Nominated By:
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Signature
*
Continue
Continue
Should be Empty: