2024 WBYA Youth Recognition Award Nomination Form
Eligibility and Nomination Instructions

1.    Nominees should reside within the boundaries of the West Bloomfield School District or be a West Bloomfield School District student, however, consideration will also be given to students residing outside of the district if they serve in the West Bloomfield community.

2.    All school age youth are eligible.

3.    A youth may receive only one award as an elementary student, one as a middle school student and one as a high school student.  A recognition letter will be sent to all nominated students who have previously received an award and are therefore ineligible for award this year due to the aforementioned rule.

4.    Nominations must be submitted through this Google form or by sending an electronic copy to connie@wbyouthassistance.org and received by Thursday, March 14, 2024.

5.    A youth nominated for an award due to volunteer service hours may not be nominated for services rendered to acquire school credits or court required community service unless the student personally chooses to continue beyond the required hours and shows dedication and commitment above and beyond what is required of them.

6.    Due to ongoing community health precautions, we understand that volunteering may look different these past couple of years for many students. We would ask nominators to think outside of the box and recognize students for unique ways they have helped others, overcome personal challenges, or persevered in face of tragedy or adversity through these challenging years.

Examples of reasons for nomination may include:
● Volunteer Service - to an individual, organization, or the community
● Personal acts of leadership, heroism and/or unexpected kindness
● Self-improvement through personal and/or academic achievement
● Remarkable perseverance through hardship or tragedy

7.    Individuals may nominate an unlimited number of students; however, nominators must fill out a separate form for each student.

8.    To make these nominations personal and meaningful, we have always invited nominators to read their remarks aloud as part of the awards ceremony to recognize each nominee. This adds a personal touch that helps the student feel recognized by someone that truly knows them. If you are unable to read your remarks, please let us know when filling out the form as we will need to plan for a board member to be available to present on your behalf. All presenters must be committed by Friday, April 21st.

Completed forms must be received no later than Thursday, March 14, 2024. Nominations may be submitted through this Google form or emailed to connie@wbyouthassistance.org.
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Email *
Date *
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Nominee's Full Name (PLEASE double check the spelling before submitting the nomination as this is what we go off of to format the certificates the student will receive) *
Nominee's School *
Nominee's Grade *
Nominee's Age *
Nominee's Full Address *
Parent/Guardian's Name(s) *
Parent/Guardian's Address (if different than the student)
Parent/Guardian's Email Address(es) - PLEASE double check this information as this is how we will send invitations to the award ceremony *
Nominee email address (if different than parent/guardian email address)
Parent/Guardian's Phone Number *
Nominator's Full Name *
Nominator's Organization *
Nominator's Email Address *
Nominator's Phone number *
In 150 words or less, please describe the nominee's accomplishment and/or special achievement. Please take care to review your submitted remarks as this will be what is read during the ceremony if your nominee is recognized. *
Do you have any additional notes or confidential comments on your nominee for the Youth Recognition Committee to consider? *
If your nominee is chosen to receive an award, would you be available to read your remarks and present the nominee with their certificates during the ceremony on Wednesday, May 10? All presenters must be committed by April 21. *
If you are unable or unwilling to read the remarks, do you have someone that would like to stand in for you? If not, we will have a WBYA board member read on your behalf.
Potential Stand In Name, Email Address and Phone Number
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