2025 Wertheimer Youth in Action Award Nomination - The Community Foundation of Frederick County

2025 Wertheimer Youth in Action Nomination Form

Please complete this form in its entirety if you wish to nominate a community youth volunteer in grades 9-12 for the 2025 Wertheimer Youth in Action Award. All nomination forms must be submitted by May 31, 2025. You will receive a confirmation email when the form is submitted. If you have any questions, please contact our office at 301.695.7660. Thank you!

Name of Nominee(Required)

First Last

Nominee's grade in school(Required)

Nominee's date of birth

Nominee's school(Required)

Address of Nominee(Required)

Street Address Address Line 2 City State ZIP Code

Phone number of Nominee(Required)

Email address of Nominee(Required)

Name of Nominee's Parent or Legal Guardian(Required)

First Last

Address of Nominee's Parent or Legal Guardian(Required)

Street Address Address Line 2 City State ZIP Code

Phone number of Nominee's Parent or Legal Guardian(Required)

Email address of Nominee's Parent or Legal Guardian(Required)

Name of person nominating volunteer(Required)

First Last

Organization (if applicable)

Address of person nominating volunteer(Required)

Street Address Address Line 2 City State ZIP Code

Phone number of person nominating volunteer(Required)

Email address of person nominating volunteer(Required)

Relationship to nominee(Required)

Describe the nominee's volunteer service. What organization(s) have they supported and for what length of time? Please include academic/school clubs and community youth involvement.(Required)

What are the qualities - the actions, services, and contributions - of your nominee that makes them such an outstanding volunteer?(Required)

How have their deeds, actions, and caring improved their community?(Required)

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