Good Kid of the Week Nomination Form

Thank you so much for your nomination for Good Kid of the Week!

Complete this form and click submit.

If your nomination is selected for the Good Kid of the Week, the parent will receive an email as well as a telephone call with the details on how the winner will receive the $10 Gift Certificate to Silver Beach Pizza.

nominate a child

Nominator Information

Nominator Name

Nominator Email

Nominator Phone

Nominator Address

Nominator City

State

Zip Code

Are you the parent or legal guardian of the nominee?

Yes No

What is your relationship to the nominee?

Nominee Information

First Name

Last Name

Nominee Address

City

State

Nominee Age

Nominee DOB

When was the act of goodness begun?

Where as the act of goodness performed?

What was the nominee’s major role in creating, implementing, and carrying out the act of goodness?

What inspired the nominee to give selflessly?

Please describe the specific actions that made a positive difference. Tell us why the nominee should receive the Good Kid of the Week Award?

Please share additional, compelling information about the nominee or the act of goodness that you feel is an integral part of the nomination?

Please share key statistics about the power of the nominee’s actions, such as ‘the number of lives impacted.”

Please provide additional supporting material about the nominee and the act of goodness, such a newspaper clipping about the nominee’s act of goodness.

I certified that I am 18 years of age or older.