The Utah Head Start Association is accepting nominations for their annual Humanitarian of the Year award, which recognizes individuals or organizations that have made voluntary contributions benefiting children, families, and communities. Nominees must have contributed their time and effort within the 2011-2012 school year. Nominations require answers to questions about the needs addressed, activities performed, positive results, and a biographical sketch of the nominee. Local Head Start programs will select winners to be forwarded to the state association by May 25th for recognition at their upcoming conference.

1. Humanitarian of the Year
Utah Head Start Association Awards
Sponsored by UHSA
Award Requirements
The Humanitarian of Year will be On a separate sheet, please type your
answers to the following questions. The
recognized at the Utah Head maximum point value for each question is
Start Association 2011 - 2012 indicated in parentheses.
conference which will be held 1. (20 points) Need: Describe the situation
before the contribution was made.
November 2, 2012 in Sandy, UT. 2. (30 points) Activity: Describe the
nominee's activity that met this need. Include
Award Criteria length of time this person has been involved in
this activity and the scope of the volunteer
Note: Failure to meet any of the services provided.
criteria below will result in 3. (30 points) Results: Describe the positive
results of the nominee's activities, who
automatic elimination. benefited, and how.
1. Nominee must be an individual or 4. (10 points) Enhancement: Support this
organization that made a voluntary nomination with letters from interested
contribution of time and effort, without regard individuals or organizations. If available,
to religious or ethnic affiliation, that has had include news reports or other documentation
a positive impact upon children, families, about the contribution.
and/or communities. 5. (10 points) Biographical sketch: Describe
2. The local program must be a current family, education, hobbies, interests,
member ofUHSA. employment, and anything else you feel is
3. The contribution must have occurred appropriate and that gives a broad picture of
within, or in preparation for, the 2011-2012 the nominee, but especially those items
school year. relevant to the award. This should be no
4. All questions must be answered in the more than 300 words (one typewritten,
entirety. double-spaced page).
May 18- 4:00 PM
Applications are due to your local Head Start program by _______________
Winners from each program will be forwarded to the Utah Head Start Association by May 25.
___________________________________ ______________________________
Name of Nominee Nominee's Email
___________________________________ ______________________________
Nominee's Address Nominee's Phone Number
___________________________________ ______________________________
Nominee's City and Zip Code Head Start Grantee Name
___________________________________
Signature of Nominee
My signature above allows the Utah Head Start Association
to disclose information from this application at the UHSA Conference