2013 Application Form
INTERNATIONAL YOUNG ECO-HERO AWARDS
First Name: Last Name(s):
City: State/Province: Postal Code:
Email: Do you identify as male or female?
Date of Birth: Age on January 15, 2013:
Name of School:
Your Web Site (if any):
Please use additional pages to answer ALL of the following questions, in order, and number your answers. Note that the maximum number of pages accepted is fifteen (including attachments). Please do not send bound copies.
1. What is the title of your project?
2. Give a one-sentence description of your work.
3. How did you hear about the International Young Eco-Hero Awards?
4. What inspired you to undertake your activities?
5. What did you do? Please be specific.
6. When did you start and end your project? If ongoing, how long do you intend to sustain it?
7. What are the goals of your project?
8. What goals have you achieved? Give dates and specifics. Use numbers (quantify) where possible,
e.g., give the number of people attending an event you might have organized.
9. How did you accomplish your goals?
10. Who else contributed to your program’s success?
11. What have you learned from your project?
12. How did this experience change you?
13. If your project is continuous please describe your involvement. Also, briefly describe any other
environmental activities you work on.
14. Regarding your project, how have you educated, persuaded and reached out to others (talks,
presentations, news articles, etc.)?
15. What are your plans for the future?
16. Supply the name, phone number and email address of an adult outside of your family who can
provide a reference upon request, and who knows about your project. Specify your relationship to
this person. Give their job title if appropriate.
17. Write a list describing your supporting materials. These could include newspaper clippings (include
name, date and page number of publication), photographs, web sites, etc. Enclose copies, not
originals, with your application. Make sure that everything is on the same sized paper, suitable for
duplication by copy machine, and remember to identify all materials with the name and the title
of your project.
Your Signature: Date:
Signature of Parent/Guardian: Date:
Printed Name of Parent/Guardian: Email of Parent/Guardian:
Applications must be postmarked by January 15, 2013 **DEADLINE EXTENDED TO JANUARY 31, 2013**
OR sent by email by that date to email@example.com
Award winners will be notified in April
Action For Nature
2269 Chestnut St. #263
Phone: (415) 513-2421
Fax: (415) 922-5717