2019 Catalyst for Positive Change Application

Syntero will host it's 28th annual Catalyst for Positive Change Awards Breakfast on Friday, May 3rd, 2019. This event will celebrate outstanding high school seniors within our community who exemplify Syntero's mission and core values: Integrity, Empowerment and Innovation. Please submit the completed student profile form below. All entries must be submitted by 8:00am on Friday, March 1st to be considered.

If you have questions or concerns contact Sarah Barr, Development Director
EMAIL: sbarr@syntero.org
PHONE: 614.457.7876 ext.237

STUDENT'S PERSONAL INFORMATION
PARENT OR GUARDIAN INFORMATION

Parent(s) name(s) (please include both first and last) or the name of another adult who will attend the breakfast with you. Please be sure to include your parents' phone number(s) (more than one if necessary), so we may call for clarification if necessary.

FIRST PERSON

(if different from student's)


SECOND PERSON

(if different from student's)

Student's Attributes and Activities
CHARACTER ATTRIBUTES

Do you participate in community based activities? Do you volunteer, participate in civic, faith-based or other outside organizations? Please list no more than four examples of your participation and involvement in the community.

UPLOAD STUDENT'S PHOTO

Use this section of the form to upload the student's head-and-shoulder shot. Maximum fill size is 10MB. Allowed format types are jpg, jpeg, png, gif. Use your last name, first name as the file name. NOTE: Send your photo as soon as possible but no later than midnight, March 1, 2019.

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NOTE: This form cannot be submitted without the student photo. Maximum file size 10MB.

SUBMIT YOUR PROFILE

Thank you for completing the Catalyst for Positive Change student profile. Take a minute to review your entries and once you are certain all information is correct type the the four characters displayed below into the box above them and click the "Submit" button.

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