Student Supporting Nomination

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Student Information

(* Required)

Student's First and Last Name*
First Last
Student's Phone Number*
Student's Address
Street Address Address Line 2 City State ZIP Code
Student's Email*
School Affiliation (can be private or public within Lake Oswego)
Year in School*
Is a Second Person Being Nominated for the Same Project/Activity?
Second Student's First and Last Name*
First Last
Second Student's Phone Number*
Second Student's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Second Student's Email*

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Brief description of Student's project/activity/service that demonstrates Service above Self.*
Length of time Student has been involved with project/activity/service
Is this a New or Ongoing Project/Activity
Start date project/activity/service (estimate if needed)
Number of People Benefited (estimate if needed)
How did you become familiar with this person's project/activity/service? (What is your connection to the Student?)

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Describe how the five "Service Above Self" criteria apply to the Student's project or activity.
Respond to all five evaluation criteria if possible. Each criterion contributes to the nominee’s overall score and ranking by the SASEE judges. The questions listed below each criterion are meant to give you ideas to consider in your response. Please do not feel obliged to provide an answer to each question. However, it is helpful if you can provide concrete examples in your responses.
1. Shows initiative and demonstrates selfless conduct toward others
Suggested details to consider:
• How did the student initiate the project/activity/service or show personal initiative in participating in it?
• How much time does the student invest in the project/activity/service?
• Does the project/activity/service meet a school need? How?
• Does the project/activity/service meet a community need? How?
• How does the student demonstrate selfless behavior toward others within this project/activity/service?
2. Inspires others to improve, grow and/or attain educational excellence
Suggested details to consider:
• In what ways does the student build an environment that positively impacts others?
• How does the student inspire or support others who are impacted by the project/activity/service?
• How does the project/activity/service involve analysis, evaluation, problem solving and decision making?
• What new skills do participants gain through their involvement with the project/activity/service?
3. Builds a strong sense of confidence, competence and/or community awareness in others
Suggested details to consider:
• Within his/her role, how did the student behave in order to develop trust and/or promote individual empowerment?
• How did the student demonstrate effective communication and organization?
• How did the student demonstrate creativity?
• How did the student encourage social responsibility in others?
4. Generates measurable impacts that leave a positive legacy
Suggested details to consider:
• What were the primary goals or objectives of the project/activity/service?
• Based on those goals, has the project/activity/service been a measurable success?
• How many people (estimate) were impacted by the project/activity/service?
• How did the student’s involvement help establish or contribute to the ongoing sustainability of the project/activity/service?
• How will the impact of the project/activity/service be measured in years to come?
5. Steady, long-standing, and active participation in community and school related activities
Suggested details to consider:
• What school-based activities is the student involved in? For how long? In what role(s)?
• Does the student play a leadership role in any of those activities?
• What community-based activities is the student involved in? For how long? In what role(s)?
• Does the student play a leadership role in any of those activities?
What else should we know about your student

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Supporting Nominator Name*
First Last
Supporting Nominator Address
Street Address Address Line 2 City State ZIP Code
Supporting Nominator Email*
Supporting Nominator Phone Number*

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Student Supporting Nomination

Student Supporting Nomination

Step 1 of 4 -

Student Information

Describe how the five "Service Above Self" criteria apply to the Student's project or activity.