... your achievement, we will gladly do so when your submission is approved. Please complete the form below and include
The Congressional Award SCHOOL/PRESS NOTIFICATION FORM
Thank you for being one of America’s great young achievers. We know you are proud of the hard work that has gone into earning The Congressional Award. If you would like for our office to notify your school and/or local press of your achievement, we will gladly do so when your submission is approved. Please complete the form below and include with your Record Book or email to our office. PARTICIPANT NAME __________________________________________________________________ LEVEL APPLYING FOR _________________________________________________________________ SCHOOL NAME ______________________________________________________________________ SCHOOL ADDRESS ___________________________________________________________________ CITY ___________________________ STATE _____________________ ZIP _____________________ SCHOOL CONTACT (PRINCIPAL, COUNSELOR, ETC.) _________________________________________ TITLE _____________________ PHONE ___________________ EMAIL _________________________ LOCAL PRESS AGENCY (NEWS STATION, NEWSPAPER, ETC.) __________________________________ PRESS CONTACT _____________________________________________________________________ WEBSITE _____________________ PHONE ________________ EMAIL _________________________ Please add me to the emailing list for news and updates from across the nation. My current email address is __________________________________________________________________ For additional information, please contact your program manager or submit an inquiry to our info desk at (202) 226‐0130 or
[email protected]. The Congressional Award PO Box 77440 Washington DC 20013
P (202) 226‐0130 F (202) 226‐0131
www.congressionalaward.org
[email protected]