Fillable 2020 Trusted Adult Award The North Reading Community (City of North Reading)

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2020 Trusted Adult Award The North Reading Community (City of North Reading)

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2020 Trusted Adult
Award
The North Reading Community Impact Team’s Youth Substance Use Prevention
Coalition and Youth Action Team is seeking nominations for the 2020 Trusted
Adult Award. We wish to recognize individuals who are making a positive impact
on the lives of our community’s youth. Please review the attached guidelines and
nomination form.
Who can be nominated? Any adults (18 or older) who are live or work in the
Town of North Reading. Organizations may not be nominated.
Who can nominate? Any youth (up to grade 12) who are citizens of the Town
of North Reading. An individual may not nominate himself or herself.
How do I nominate someone? Complete the Trusted Adult Award
Nomination Form, and submit it to the Community Impact Team as instructed on
the form, no later than Friday, September 4, 2020.
How are winners selected? Up to 3 winners will be selected by the
Community Impact Team’s Youth Action Team based on the nominations.
What is the prize? Winners will be presented with a 2020 Trusted Adult Award
at the Community Impact Team Breakfast (date to be announced) and
announced in the media.
Can I submit additional documents with my nomination? Each entry
may also be submitted with the following: photographs (5 max), video (no longer
than 2 minutes), and/or letter of recommendation (2 max). Nomination
documents and all media will not be returned and become property of the CIT.
Can I nominate more than one person?
Each youth may nominate up to 2 individuals.
Who can I contact with questions? You may
contact Amy Luckiewicz at coalition@northreadingma.gov.
2020 Trusted Adult Award
Nomination Form
Nominee Name___________________________________________________
Nominee Address_________________________________________________
Phone_____________________ Email____________________________
How do you know the nominee?_______________________________________
________________________________________________________________
________________________________________________________________
Why is the nominee a trusted adult to you?______________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Who has the nominee impacted as a result of his/her/their work?_____________
________________________________________________________________
________________________________________________________________
Additional considerations____________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Nominated By____________________________________________________
Phone_____________________ Email____________________________
Please submit your nomination by Friday, September 4, 2020 to
Amy Luckiewicz at The North Reading Police Department 1
50 Park Street * North Reading, MA 01864
or email coalition@northreadingma.gov
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2020 Trusted Adult Award The North Reading Community (City of North Reading)

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Completed 14 July 2020

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