Click here for an interactive PDF version of the application form and Guidelines.

Read the Announcement
Read the Guidelines

Contact Information of Applicant

First Name _______________ Last Name ____________________
Address _________________________________________________
City _____________ State/Province ____ Postal Code ______
Phone _______________________ Fax _______________________
Email ______________________ Are you male or female? ____
Date of Birth _____________ Age on January 15, 2012 ____
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 15 (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 enclosures with the name and the title of your project.

Signature ___________________________ Date ______
Signature of Parent or Guardian ______________ Date _____
Printed Name of Parent or Guardian _____________________
Email Address of Parent or Guardian ____________________

Applications must be postmarked by January 15, 2012
or sent by e-mail by that date to awards AT actionfornature.org
Award winners will be notified in April 2012

Action For Nature
2269 Chestnut St. #263
San Francisco, CA 94123 U.S.A.
Phone: 415-513-2421
Fax: 415-922-5717
Email: awards AT actionfornature.org