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Character Counts Nomination Application

 City of Highland Park
Character Counts Pillar Award
2021 Nomination Form

The Highland Park Character Counts Steering Committee selects and presents the "Character Counts Pillar Awards”. The Committee is now seeking nominations for individuals who continuously exhibit good character. Nominees often include students, community and athletic volunteers, neighbors, etc.

  • Individuals must live, work, volunteer, or attend a school within the North Shore School District 112 boundaries. 
  • Criteria for the nomination does not include activities performed within the normal scope of one’s job. 
  • Nominations must be submitted by someone other than a family member. 
  • Students may be awarded one (1) CCPA throughout their academic career; Adults may be awarded one (1) CCPA as well.

Application Deadline: Wednesday, March 31, 2021.

To be considered, a nominee’s beliefs, attitudes, and actions should consistently exemplify the Six Pillars of Character. The Six Pillars of Character are as follows:

  • Trustworthiness: integrity, honesty, reliability and loyalty
  • Respect: valuing all people, living by the Golden Rule, honoring the dignity, privacy and freedom of others, courtesy, politeness, tolerance, and acceptance of differences
  • Responsibility: fulfilling duties, accountability, pursuing excellence, and exercising self-control
  • Fairness: being just, impartial, and having both a willingness to listen and an openness to different viewpoints
  • Caring: being compassionate, kind, loving, considerate and charitable
  • Citizenship: doing one’s share, helping the community, playing by the rules and respecting authority and law

 Please complete the following information:

Nominee Information:

Name:

Address:

City or Town:

State or Province:

Zip or Postal Code:

Phone:

Email:


Parent/Guardian Name (if under 18): 


Parent/Guardian Phone (if under 18):


Parent/Guardian Email (if under 18):


School or Place of Employment:


Student       Employee       Business Owner       Resident  

Which of the Six Pillars does this nominee best exemplify?


Nominator's Information:

Name of Nominator or Nominating Group:

(For recognition purposes during the ceremony; for example: Kennedy 5th Grade Team, or West Ridge Staff.)

Name of Contact:

Address:

City or Town:

State or Province:

Zip or Postal Code:

Phone:

Email:


Relationship to Nominee:

Number of years acquainted with Nominee:

Please describe why your nominee is deserving of a Robert Barnard Character Counts Pillar Award. Please include which Pillars best exemplify the nominee and include a specific example demonstrating those Pillars.  Please write in third person narrative, as portions of this description may be included in the awards ceremony. (800 character maximum.)