Congratulations!

Your School Selected You To Receive A Catalyst For Positive Change Award

Your hard work and dedication to creating a better world, has not gone unnoticed. Syntero is hosting a breakfast to honor you and your fellow award recipients, Friday, April 17 at the Brookshire Event Venue in Delaware, Ohio.

Please let us know that you accept this honor by completing the profile form below by Friday, February 20. We can't wait to share your story, and we look forward to learning more about how you are creating positive change at your school and in your community.

*You may want to review the questions below and prepare your answers before completing the profile as this form does not have a save feature.

Click here to view event information.

Catalyst Award Student Profile

First Name

Last Name

Preferred First Name/Nickname

How to Say Your Full Name

Preferred Email Address

High School Name

Parent/Guardian 1

Parent/Guardian 2

Phone

Parent/Guardian 1 Email

Parent/Guardian 2 Email

Please share how you embody the selected value in your volunteerism and/or community.

Please list up to 10 volunteer, civic and school activities/memberships along with any titles, if applicable, separated by semi-colons (i.e. student council, president; Dublin Food Pantry, volunteer; ):

Please share what or who motivates you to be involved at your school and in your community.

Please share ONE fond memory you have of volunteering or community/school involvement and explain how the experience has positively impacted you.

Please upload a recent photo of yourself with no other people in the picture. Photos will be used as head shots in the event presentation, program, and marketing and may be cropped, if needed.

Upload File

Upload supported file (JPEG/PNG). Max 15MB.

Select all that apply:

I am willing to do media interviews about creating positive change in our community

I am willing to be featured on Syntero's social media accounts

I agree to be photographed during the event and that any photos taken of me become the property of Syntero, Inc. who may use them for marketing or fundraising purposes.

I am 18+ years old and have the legal ability to agree to any or all of the above.

I am under age 18 and will need my parent(s) to sign a release for any or all of the above.

Thank you for all that you do to be a Catalyst for Positive Change.
We look forward to celebrating with you.

Thanks for submitting your profile!

Congratulations!

Your School Selected You To Receive A Catalyst For Positive Change Award

Catalyst Award Student Profile

Select all that apply:

Thank you for all that you do to be a Catalyst for Positive Change. We look forward to celebrating with you.

Thank you for all that you do to be a Catalyst for Positive Change.
We look forward to celebrating with you.