Community Impact Award
Dennis Richmond Award Application
I have read the
Award Guidelines and Award Nomination Process
on Ala Costa Centers’ website.
Name of Nominee:
*
Public School of Employment:
*
Position:
*
Contact Information
Phone Number:
*
Email Address:
*
Contact Information (of person making nomination)
Name:
*
Address:
*
State:
*
Zip Code:
*
Phone Number:
*
Email Address:
*
Question
Describe the ways the nominee went above and beyond their job description to better the life of youth in
the community. (max. 500 words)
*
* denotes a required field
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