The 2015 Sharon Jordan/PFLAG Canada Brockville Rainbow Award for Secondary Students ! Recognizing Secondary Graduating Students for Embracing the Lesbian, Gay, Bisexual, Transgender, Two-Spirit, Queer and Questioning (LGBTQ) Community and Ending Discrimination in their School and/or the City of Brockville The 2015 Sharon Jordan/PFLAG Canada Brockville Rainbow Award for Secondary Students seeks to recognize youth who are graduating from a Brockville High School in June 2014, and who have embraced the Lesbian, Gay, Bisexual, Transgender, Two-Spirit, Queer and Questioning (LGBTQ) Community by working towards ending discrimination in their school and/ or the City of Brockville. The ideal candidates for this award will be students who have sought to encourage and promote the acceptance and appreciation of the Lesbian, Gay, Bisexual, Transgender, Two-Spirit, Queer and Questioning Community (LGBTQ) through school and/or city-wide initiatives. Possible avenues for consideration could include organizing a school-wide Day of Pink activity or Gay Straight Alliance (GSA) or promoting inclusive and/or antihomophobic language. Nominees for this award must be Canadian citizens or residents and must be graduating from a high school in the city of Brockville, Ontario as of June 2015. Students do not have to be continuing on to Post-Secondary education to be eligible to receive this award. ! Awards of $250.00 will be given to selected students as determined by a panel of judges consisting of Sharon Jordan and members of PFLAG Canada Brockville. All entries will be kept strictly confidential and all information will be destroyed three (3) months after the closing date for the application process. Awards selection is not open to appeals. Information collected for this award will not be used for other purposes; outside of media and school publicity. ! ! Winners of the 2015 Sharon Jordan/PFLAG Canada Brockville Rainbow Award for Secondary Students will be presented with their award at their Commencement Ceremony. Should a winner of the award wish their identity to remain anonymous, arrangements can be made with the selection committee for a non-public presentation of the award. To apply for 2015 Sharon Jordan/PFLAG Canada Brockville Rainbow Award for Secondary Students must: 1. Fill out the 2015 Sharon Jordan/PFLAG Canada Brockville Rainbow Award nomination form for Secondary Students (be sure to include two-signatures from your friends or peers attesting to your accomplishments as well as a member of your school staff). 2. Include a write-up, photo-essay or any final submission “product” of your choice that clearly indicates why you are deserving of the 2015 Sharon Jordan/PFLAG Canada Brockville Rainbow Award for Secondary Students. Please ensure that digital submissions are in PC compatible formats and can easily accessed through common applications. Submissions will only be returned to the applicants upon request. The deadline for submissions is 4 pm on Friday May 15th, 2015. Late or incomplete submissions will not be considered. Students who may be returning to high school after graduation are eligible to apply the following year, but must submit a new application. Please mail or email the Nomination Form and your Submission for Consideration to: Mail: Sharon Jordan Brokerage C/O Royal LePage ProAlliance Realty, 2A -2495 Parkdale Avenue Brockville, ON K6V 3H2 Email: jordan@ripnet.com Phone: 613-213-0632 2015 Secondary Student Nomination Form The 2015 Sharon Jordan/PFLAG Canada Brockville Rainbow Award for Secondary Students: ! ! ! ! ! ! Recognizing Secondary Graduating Students for Embracing the Lesbian, Gay, Bisexual, Transgender, Two-Spirit, Queer and Questioning (LGBTQ) Community and Ending Discrimination in their School and/or the City of Brockville Part A: Applicant’s Information ! ! Applicants Name: ! Address: ! Phone Number: ! Email: ! School: ! ! Part B: Two (2) peer signatures attesting to the applicant/nominee’s accomplishments: ! ! Peer Signature #1 Please Print Name and Grade Below ! ! Peer Signature#2 Please Print Name and Grade Below Part C: Signature of staff member attesting to the applicant/nominee’s accomplishments School Staff Signature Please Print Name and Position Below
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