Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Dr. Martin Luther King, Jr., 45th Annual STUDENT Humanitarian of the Year Award

Sign in to Save Progress
  2. Contra Costa County
  3. Contra Costa County Board of Supervisors Seeks Nominees for Student Humanitarian of the Year

    In addition to being an adult honoree, Contra Costa County proudly honors a high school student each year who is an inspiration to fellow students. This year's theme is "The Future Belongs to All." We invite teachers, coaches, and other school staff to submit the nomination information below. Please use the form below to submit information before November 4, 2022.

  4. Dr. Martin Luther King, Jr.
  6. Dr. Martin Luther King, Jr., 45th Annual STUDENT Humanitarian of the Year Award

    Please use the following form to submit your nominee for Contra Costa County Student Humanitarian of the Year.

  8. 1. Nominee Information
  15. 2. Nominator Information

    Please tell us how we can reach you to get additional information.

  25. 3. Please upload a document describing your student nominee.
    Please share your thoughts about the student, and why this individual is deserving of the honor. We are looking for students who stand out to their teachers, family and peers. Our winner will be someone who sets an example for others, and lives Dr. King's dream of equality, peace, justice, non-violence, leadership and inspiration. Please be as specific as you can.
  29. 4. Alternatively, use this section to describe your nominee's leadership, integrity and commitment.

    If you prefer to enter your information directly on this form rather than attach a document, please use this space to explain your nominee's leadership and/or commitment to promoting diversity, equality, peace, justice and non-violence.

  33. Submit this form no later than 11:59 PM on Friday, November 4, 2022.

    Announcement of the selection of the 43rd Annual Student Humanitarian of the Year will be made by early January. We will contact you directly if we have any questions about your submission.

  35. 5. Please upload an image here. Contact the Awards Committee if you need assistance.
    If the student you nominated is selected, the Committee will need a high resolution JPEG format picture of the student to be used in the program for the ceremony and in a news release to the media. Please upload an image here, or if you need assistance email [email protected].
  39. Thank you for your nomination.

    Plan on joining us for the event on Tuesday, January 17, 2023, at 11:00 a.m. for our annual Dr. Martin Luther King, Jr., Day celebration. If your nominee is selected, you will be contacted with information and other arrangements for the day of the ceremony. Awards will be presented during the celebration, and the Humanitarian of the Year will be formally recognized by the Board of Supervisors with an opportunity to say a few words.

    42. Leave This Blank:

  44. This field is not part of the form submission.