Take the Challenge Home Award Application

To apply for the Take the Challenge Home award, please fill out the application form below.

Deadline: December 1, 2009. Awards to five community coalitions will be announced December 15, 2009. The winners will be awarded $5,000 from Ready by 21 and a $1,000 certificate from Search Institute Survey Services. To find out more, see the Take the Challenge Home award page.

Contact Information

Name:

Title:

Organization:

Coalition Name:

Address:

City:

State:

ZIP:

E-mail:

Work Phone:

Cell Phone:

Coalition Information

Year your coalition was established:

Stakeholders:

List the stakeholders or key groups and individuals in your coalition and their level of authority.

Identify activities that your coalition provides in these five areas:

1) Engage adults:

How does your coalition engage adults to develop sustained, strength-building relationships with children and adolescents?

2) Mobilize young people:

How does your coalition mobilize young people to use their power as asset builders and change agents?

3) Activate sectors:

How does your coalition activate sectors of the community (such as school, congregations, businesses, and health care) to contribute to young people’s healthy development?

4) Invigorate programs:

How does your program invigorate programs to become asset-rich and available to all children and youth?

5) Influence civic decisions:

How does your coalition influence civic decisions in support of a positive transformation of community?

Current governing structure of your organization:

Current level of youth engagement and youth leadership in your coalition (please provide examples):

The goals of your coalition:

How does your coalition collaborate with other groups or initiatives in your community?:

How will your coalition benefit if it awarded one of these five awards?:

Please attach letters of support from at least three key stakeholders.

Letter of Support 1:

Letter of Support 2:

Letter of Support 3:

Additional Document 1:

Use this to upload additional letters of support or other supporting documents.

Additional Document 2:

Use this to upload additional letters of support or other supporting documents.

Date:

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