ApplyPFA

Prize for Achievement - Online Application Form
Nomination Deadline - April 30, 2020

The Prize for Achievement award is given to an individual who has successfully completed or is currently operating
an endeavor that benefits both themself and society.
If you experience any issues or have questions about the process, please contact foundation@kurtgiessler.com

Needed Forms to Complete Nomination (PDF)

Nominee's Initiative Information

* Indicates required field

Description of Completed or Ongoing Intiative *

Nominee's Initiative Information

Nominee Name *

First

Last

Date of Birth (mm/dd/yyyy) *

Nominee's Address *

Line 1

Line 2

City

State

Zip Code

Country

Nominee's Email Address *

Nominee's Phone Number *

Nominator Information

Nominator's Name *

First

Last

Nominators Date of Birth *

Nominator's Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

How did you hear about us? *

Forms, Documents, and Materials

Please Note: Your nomination is not complete until you have uploaded: Letter of Nomination, Prize for Achievement Certification Statement,
Applicant Consent Form, and a Parent/Guardian Consent Form (if applicant is under 18).
These can be uploaded on the following page.

Letter of Nomination (on Letter Head of School, Org, Comp.) *

Max file size: 20MB

P of A Certification Statement *

Max file size: 20MB

Applicant Consent Form *

Max file size: 20MB

Parent / Guardian Consent Form (if applicant is under 18 on the day of the deadline) *

Max file size: 20MB

Submit

Prize for Achievement - Online Application FormNomination Deadline - April 30, 2020

Nominee's Initiative Information

Nominee's Initiative Information

Nominator Information

Forms, Documents, and Materials

Prize for Achievement - Online Application Form
Nomination Deadline - April 30, 2020