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Tri-City R.E.A.C.H. Awards Nomination Form
2018 Tri-City R.E.A.C.H. AWARDS: Recognizing Efforts and Achievements across Community & Home

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The Tri-City R.E.A.C.H. Awards recognize the generous contributions of individual youth, youth groups, businesses, organizations, and adult mentors in Coquitlam, Port Coquitlam and Port Moody who empower, celebrate, and/or impact youth and the community in significant ways. This year's event will celebrate the artistic beauty and magnificence of the natural world. Nature will inspire the evening's events, décor and entertainment.
DEADLINE: Please submit nominations online at portmoody.ca/youth or in-person by April 3, 2018

NOTE: One submission per nominee.

Please nominate a youth or youth advocate who has contributed to the community or positively supported youth (11 to 18 years).
NOTE: All eligible nominees will be recognized and expected to attend the REACH Awards Ceremony on Wednesday May 9, 2018, 6pm-8pm at the Inlet Theatre/Galleria – 100 Newport DR, Port Moody.

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NOMINATION CRITERIA

Individual Youth or Youth Group

Individual youth or members of youth group must be in grades 6-12.

Examples include:
*Nominee volunteered consistently on behalf of others, the community, and/or the environment.
*Nominee has been a positive role model for their peers and/or is committed to community service.
*Individual has overcome adversity in his/her life.

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Business or Organization

Any local non-profit, private or public organizations such as: community service organizations, stores, restaurants or government agencies who have made a positive contribution to youth.

Examples include:
*Nominee provides funding/space, fundraising initiatives, creates positive opportunities, offers free or low-cost youth programs, specializes in youth employment, influences safety for young workers, etc.

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Individual Adult Mentor

An adult who volunteers or works for the benefit of youth. Nominee must be a positive role model who has made a special effort to support youth in the community.

Examples include:
*Coach, teacher, youth worker/counsellor, mentor, neighbour, friend, etc.

Who are you nominating? Please select one.*
Nominee Information

If nominating a group of people, please identify the group leader's information below. Additional group members will be listed separately in another field.

Nominee Name (Last, First) or Group Leader:*
Address:*
City*
Grade (if applicable):
School (if applicable):
Phone Number (Home):*
Phone Number (Cell):
Email:*
If nominating a group, please list all group members (Last name, First name) & Email Addresses:
Parent/Guardian Information (for nominees <19 years)
Name (Last, First):
Phone Number (Cell):
Email:
What qualities, skills and characteristics make this nominee a good candidate for a Tri-City REACH Award? (e.g. goal oriented, strong work ethic, ability to work well under pressure, innovative ideas & development)

List the specific community service/volunteer work that the youth/youth group has accomplished OR list the ways that the business/organizations or adult mentor has supported youth in recent years. (e.g. participated in a graffiti removal program, business provided food donations for youth dinners)

How has the nominee’s effort made a positive difference to youth in the community? (e.g. volunteered in a soup kitchen and fed over 500 people, provided opportunities for youth to attend special events)

What other interesting facts would you like us to know about the nominee? (e.g. sponsored a child in Africa for three years, loves rock and roll music and plays free concerts in the community) - Cloned

Nominator Information:
Name (Last, First):*
Address:*
City:*
Relationship to Nominee:*
Phone Number (Cell):*
Email:*
Business/Organization (if applicable):
Additional Information:

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