2021 Catalyst for Positive Change Application

Syntero will livestream its 30th annual Catalyst for Positive Change Awards Breakfast on Friday, April 16, 2021 at 8:00 AM. This event will celebrate outstanding high school seniors within our community who exemplify Syntero's mission and core values: Integrity, Empowerment, Innovation and Inclusiveness. We understand that community service opportunities have been limited due to the COVID-19 pandemic; however, we will celebrate the community impact of amazing Central Ohio high school students who exemplify Syntero's values, as well as students who have discovered innovative ways to support themselves or others during this time.​ Please submit the completed student profile form below. All entries must be submitted February 1st thru February 26th in order to be considered.

If you have questions or concerns contact Mariah Beidleman, Chief Public Information & Development Officer.
EMAIL: mbeidleman@syntero.org
PHONE: 614.767.9510

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 ACTIVITES
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, February, 26, 2021.

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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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