Parent of the YearUtah State Head Start Association State Awards

Sponsored by UHSA

Award

The 2012 - 2013 Parent of the YearAward will be recognized at theUtah Head Start Associationconference which will be heldNovember 8, 2013 in Sandy, UT.

Award Criteria

Note: Failure to meet any of thecriteria below will result inautomatic elimination.

1. Applicant must have been a Head Startparent and not a paid employee during theschool year of 2012 - 2013.2. Applicant must have participated on theParent Committee, Policy Committee, PolicyCouncil or UHSA during 2012 - 2013..3. Local program must be a current member ofUHSA.2. All questions must be answered in theirentirety.

Requirements

On a separate sheet, please type youranswers to the following questions. Themaximum point value for each question isindicated in parentheses.1. Describe activities contributed by theparent to the local program or in role asleader, (20 points)

2. Describe accomplishments and/oractivities related to the continuous personaland career development of the parent. (30points)

3. Describe your personal goals: Theapplicant should write a statement ofpersonal goals no more than 200 words inlength. (30 points)

Applications are due to your local Head Start program by _______________Winners from each program will be forwarded to the Utah Head Start Association by May 24.

_____________________________________________ ______________________________________________Name of Nominee Nominee's Email

_____________________________________________ ______________________________________________ Nominee's Address Nominee's Phone Number

_____________________________________________ ______________________________________________ Nominee's City and Zip Code Nominating Head Start Program

_____________________________________________ _________________________Signature of Nominee Total # of volunteer hours for Head Start

My signature above authorizes the Utah Head Start Association from September 2012 - May 2013

to disclose information from this application at the UHSA conference.