CITIZENSHIP AWARDS APPLICATION FORM

(Please Print)

Child’s Name _________________________________________________________________________

Address _____________________________________________________________________________

Telephone Number ____________________________________________________________________

Age ____________ Birth date _____________________ Grade in School ____________ ڤFemale ڤMale

ELIGIBILITY

Must be 8-11 years old, or in the 3rd—5th Grade, on April 18th, 2003

Must be a student in the West Monona School system

Must be available for the contest on May 17, 2003

MUST INCLUDE with this application, one letter of recommendation explaining why the applicant should be an Onawa Young Ambassador. The recommendation may be written by a teacher, family member, or anyone associated with the child who is aware of the child’s helpful, courteous and conscientious behavior depicting good citizenship.

All applicants are invited to attend the Recognition Day Picnic on Saturday, May 3rd. 5 female and 5 male finalists will be announced in May. These finalists will participate in the Citizenship Awards Ceremony on Saturday, May 17th, at the Onawa Community and Recreation Center, 320 10th Street, Onawa, Iowa.

Send application form and letter of recommendation to: Onawa Young Ambassador Citizenship Award, 320 10th Street, Onawa, Iowa, 51040. Or return applications to the Onawa Community and Recreation Center by April 18, 2003.

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Signature of Parent or Guardian