Awards Nomination Form

Amazing Kid Nomination Form

Please use this form to nominate an Amazing Kid. Nominee must be 18 years or younger and personally raised $500 or more for Water for South Sudan. Selected nominees will be featured in an upcoming email newsletter or social media post (with parent/guardian permission).
Nominee Information
Nominee Name

First NameLast Name
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number

Area CodePhone Number
Parent/Guardian E-mail Address
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reason For Nomination
In 300 words or less, explain why your nominee is an Amazing Kid.
Your Information
Your Name

First NameLast Name
Your E-mail Address
Your Phone Number

Area CodePhone Number
Your Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Relationship to Nominee
Should be Empty: