Nominate a Child Please enable JavaScript in your browser to complete this form.NOMINATE A CHILDNominator InformationNominator Name *FirstLastNominator Email *Nominator Phone *Nominator Address *Address Line 1Address Line 2City- Please select your state -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAre you the parent or legal guardian of the nominee? *YesNoWhat is your relationship to the nominee? *Parent/Guardian InformationParent/Guardian Name *FirstLastParent/Guardian Email *Parent/Guardian Phone *Parent/Guardian Address *Address Line 1Address Line 2City- Please select your state -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhat is this person's relationship to the nominee? *Nominee InformationNominee Name *FirstLastNominee Address *Address Line 1Address Line 2City- Please select your state -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNominee Age *Award Committee judges are looking at certain criteria, which include, but are not limited to 1) the extent of the role the Nominee played in creating, implementing, and carrying out the act of goodness or longer-term initiative that has made a significant difference in the lives of others; 2) the extent and manner in which the act of goodness or longer-term initiative has improved the lives of others; 3) the measurable difference the act of goodness or longer-term initiative has made, based on the number of people touched by the act of goodness.Specifically, what was the act of goodness performed/initiated by the nominee on behalf of people in desperate need of help and support? *When was the act of goodness performed/initiated? *Where was the act of goodness performed/initiated? *What was the nominee's major role in creating, implementing, and carrying out the act of goodness? *What inspired the nominee to give selflessly to help people desperately in need? *Describe the specific actions that made a positive difference in the lives of others who are struggling and in need of help and comfort. Tell us why the nominee should receive the Children Have the Power to Empower Award. *Provide key statistics about the power of the nominee's actions, such as "the number of dollars raised" or "the number of lives impacted.” *Share additional, compelling information about the nominee or the act of goodness that you feel is an integral part of the nomination.Provide additional supporting material about the nominee and the act of goodness, such as a photograph of the nominee, a newspaper clipping about the nominee's act of goodness, and contact information for the people and/or organizations that benefited from the nominee's selfless act of goodness.File Upload Drag & Drop Files, Choose Files to Upload You can upload up to 3 files. Checkboxes *I certify that I am 18 years of age or older.Checkboxes *I acknowledge that I have read, understand, and agree to comply with all Official Rules & Guidelines of the Children Have the Power to Empower® Award program.EmailLeave this field emptySUBMIT
