Youth Citizenship Award Nomination Form

The Cattaraugus County Youth Bureau has long sought to recognize outstanding young citizens of Cattaraugus County. While academic achievements are important, extra consideration is given to those youth who have shown a strong interest in serving in their communities and volunteering to help others.

Each week, one of the chosen youth will be featured in local newspapers along with a brief bio and listing of their community and school involvements and achievements. Traditionally, a banquet is held each spring to honor the award recipients.

If you know of a graduating senior residing in Cattaraugus County who would be deserving of this award, please fill out a nomination form for the Cattaraugus County Youth Citizenship Award.

Download Youth Citizenship Award Nomination Form

Completed forms should be mailed or emailed with a color photo (.jpg format if emailed) to Alison Crosson at the Youth Bureau.

Please contact Alison Crosson with questions by phone at 716-938-2617 or using the Youth Bureau's contact form.

Nominee Information

Please add a color school photograph

Nominator (you)
Community Service and Citizenship

Please list all community-based organizations and volunteer service that the nominee has served for at least one year.
Please list the # of days/year of service/role in each group.
(i.e. youth groups, religious groups, Youth Court, Scouts, 4H, etc.)
Please do not abbreviate or use acrynoms.

Extracurricular Activities

(Please list all school-based extracurricular activities in which the student currently is participating in, i.e. Honor Society, Math Clubs, Key Club, Band, Chorus, SADD, peer leadership groups, etc.)

Please list all school-based extracurricular activities in which the nominee has actively participated in for at lease one year.
Enter # of Year(s) Participating / Leadership Role.
(i.e. Honor Society, Math Club, Chrous, peer leadership groups, Interact Club, etc.) For band, please state instrument that the student plays.

Please enter the Sports Teams, total # of Year(s) Participating and positions played.

Educational Record
Personal Information

Please add any interests or hobbies not mentioned previously

Rationale

Why are you nominating this particular student?

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