10th Annual
Ken-Ton Friends of Youth Foundation, Inc.
"Charlie Wolff Memorial Award"
Educational Grant Application
Recommendation Form
DUE NO LATER THAN April 30, 2008
 
  Nominee's Name:________________________________________________________________
  Address:_______________________________________________________________________
 _______________________________________________________________________________
 Phone:_________________________  Date of Birth:___________________________
  School: _______________________________________________________________________
  Year/Grade:_______________

Recommended By: Name: ______________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________________
Phone: ____________________________________________________________________
Parent(s)/Guardian(s) Name: _____________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________________
Phone: ____________________________________________________________________

 If you need assistance, please call
Dennis Gallagher at 361-5764

Please complete the following to the best of your knowledge.
NOTE: The Charlie Wolff Memorial Award is for young people from the Kenmore-Town of Tonawanda area who will graduate or acquire their GED by June 2008 and who are often overlooked, struggling to be successful and need assistance to achieve. Use examples-be-specific-your words can make the difference!

 

 

 


 Recommendation Form - "Charlie Wolff Memorial Award"

 Nominees's Name: ________________________________________________

 1. Why do you feel this student is deserving of this most special recognition/incentive? Have they overcome barriers and are they sincerely trying to be successful? What makes them unique among their peers? Be specific. Provide examples where possible (Use extra sheet of paper if necessary but please Mark it answer #1).

 

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2. Any family, personal or other circumstances that affected achievement as the nominee in school, work,or community activities? (Use extra sheet of paper if necessary but please mark it answer #2)

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____ Check if additional pages are attached.

 

 

 

 


 Recommendation Form - "Charlie Wolff Memorial Award"

 Nominees's Name: ________________________________________________

 3. Extracurricular activities undertaken by Nominee including school, community, or other.
(Use extra sheet of paper if necessary but please mark it answer #3)

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4. Has the Nominee been recognized in the past with any awards or other distinctions? If so, what?
(Use extra sheet of paper if necessary but please mark it answer #4)
 
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 5. Any special financial concerns? If so, what? (Use extra sheet of paper if necessary but please mark it answer #5)

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____ Check if additional pages are attached.

 

 

 


 Recommendation Form - "Charlie Wolff Memorial Award"

 Nominees's Name: ________________________________________________

 6. What are the Nominee's future plans? Continue education? Enter the working world? Please be specific. (Use extra sheet of paper if necessary but please mark it answer #6)

 

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 7. If entering the working world, what type of employment or occupation? Full or part-time?
(Use extra sheet of paper if necessary but please mark it answer #4)
 
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8. If continuing education, where will the nominee be attending and what will he/she be studying?
(Use extra sheet of paper if necessary but please mark it answer #4)

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____ Check if additional pages are attached.

 

 

 

 

 

 

 

 Recommendation Form - "Charlie Wolff Memorial Award"

 Nominees's Name: ________________________________________________

 Please provide Two References, other than family, who could be contacted regarding this nomination.

Name ________________________________________________________________________
 
Address ______________________________________________________________________

 Phone: ______________________________Relationship: ____________________________
 

Name ________________________________________________________________________

Address ______________________________________________________________________
 
 Phone: ______________________________Relationship: ____________________________
 

 

 Please Return The Completed Original Form and 4 copies To:

Ken-Ton Friends of Youth Foundation, Inc.
P.O. Box 607
Kenmore, N.Y. 14217

- Due No Later Than April 30, 2008 -

 

For more information on the
Ken-Ton Friends of Youth Foundation, Inc.
please visit our web site at:

 
www. kentonfriendsofyouth.org