Harvey County Partnership/Communities In Schools Inc.


816 Oak Street, P.O. Box 91,

Newton, Kansas 67114

(316) 284-6520

Fax (316) 284-6234

Email: hcpcis@southwind.net

We’re centered on helping you!

 

CHILDREN’S FRIEND OF THE MONTH AWARD NOMINATION

 

 

Award Description: This award is to recognize the efforts of the nominee who provides or secures services that contribute to the health, safety and well being of children birth to age 18 in Harvey County. Services may include, but are not limited to, any of the following; direct care, referrals, evidence of respect, and/or community advocacy for children. An individual child/youth or group of children/youth may be the recipient(s) of service from the nominee. Award recognition will be a certificate and a gift of appreciation.

Award Eligibility:

  1. Nominees may be an individual or group. (Individual need not be a Harvey County resident, but employed in the county.)
  2. Award will be presented to an individual/group only one time within a year.

Nomination Rules:

  1. Anyone may nominate an individual/group for this award.
  2. Nominations must be completed on the form provided through the HCP/CIS office or the website www.newtonplks.org/comrsrc/.
  3. Nominations are due in the Harvey County Partnership/ Communities In Schools office the 1st of each month.
  4. Nominations may be mailed, emailed, or fax to the Harvey County Partnership/CIS office. It must be received by the 1st of the month.
  5. Nominations submissions may be typed or hand written (in ink.)
  6. All submissions become the property of the Harvey County Partnership/CIS and may be used in media releases. No applications will be returned.

In the space provide on the form give a description of how this person/group provided or secured services that contributed to the health, safety, and well being of children birth to age 18 in Harvey County this month. What type of impact did this person make on the life of a child/children in our community? If known, please provide any background information on how this person/group contributes to the city and/or county, i.e. membership in service organizations, etc.

3/1/02

Harvey County Partnership/Communities In Schools Inc.


816 Oak Street, P.O. Box 91,

Newton, Kansas 67114

(316) 284-6520

Fax (316) 284-6234

Email: hcpcis@southwind.net

We’re centered on helping you!

 

CHILDREN’S FRIEND OF THE MONTH AWARD NOMINATION

Please print or type

MONTH/YEAR of Nomination ________________

Name of Nominee: ________________________________

Nominee Mailing Address: _________________________________________

(street, city, zip)

Nominee Day time Phone Number: __________________

How did this person/group contribute to the health, safety and well being of a child or children in Harvey County? What specific action makes you want to nominate this person/group?

 

 

 

 

 

 

What type of impact did this person/group make in the life of a child/ren?

 

 

 

 

What role, if any, does this person/group contribute to his/her community? (memberships in community service organizations, etc.)

 

 

Nominator’s Name: ______________________________

Day Phone Number: _______________

Email Address (if any) _______________________