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K-12 Student Citizenship Nomination

Note – Students of our community schools and Vista Virtual School can be nominated for Citizenship Awards.

K-12 Student Citizenship Nomination Form

Please note - All nominations must be supported by the school principal. Nomination deadline is May 1st.

Nominator's Name
First Last
Describe your relationship to the student you are nominating. ie. teacher, friend, etc.
NOTE - Family members CANNOT submit nominations for a relative. ie., parent cannot nominate child, sister cannot nominate brother.
Email
Phone
Student Information
Student Name
First Last
School
Grade
Award Criteria
Nominations must include statements or examples of HOW the student meets at least three (3) of the award criteria.
Select three (3) or more items from the following list.*
For each item selected, you will be prompted to enter details of how the student meets each criteria.
- Demonstrates responsibility
- Helps/supports others
- Has a positive attitude
- Displays kindness to others
- Works towards goals
- Listens to others
- Is honest
- Has the courage to do what is right
- Respects others
- Shows concern for others
- Is dependable
Demonstrates responsibility*
Describe how the student meets this criteria. Include specific examples.
Helps / supports others*
Describe how the student meets this criteria. Include specific examples.
Has a positive attitude*
Describe how the student meets this criteria. Include specific examples.
Displays kindness to others*
Describe how the student meets this criteria. Include specific examples.
Works towards goals*
Describe how the student meets this criteria. Include specific examples.
Listens to others*
Describe how the student meets this criteria. Include specific examples.
Is honest*
Describe how the student meets this criteria. Include specific examples.
Has the courage to do what is right*
Describe how the student meets this criteria. Include specific examples.
Respects others*
Describe how the student meets this criteria. Include specific examples.
Shows concern for others*
Describe how the student meets this criteria. Include specific examples.
Is dependable*
Describe how the student meets this criteria. Include specific examples.
Please attach any supporting documents. (Letters, references, etc.)
Consent
By submitting this form I agree to the disclosure of my name in the public announcement of the award.
CAPTCHA

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