the PDF

CAP COM is awarding a total of $6,600!
CAP COM’s Making a Difference Awards are given to
middle and high school students who show outstanding
commitment to community service and volunteering.
The awards celebrate teen members who embody the
credit union philosophy of “people helping people.”
Nominations for teens age 13-18 can be made by a
parent, grandparent, teacher, friend or member of the
organization where the community service was done.
Teens can also nominate themselves.
Six winners will each receive a $1,000 cash award
plus $100 to donate to the charity of their choice.
To nominate a teen:
•Complete the Application Form found on the back of this flyer or online at www.capcomfcu.org/scholarships.
• Request a letter written and signed by a representative from the organization, if applicable, explaining how the
nominee is making a difference in the community. Include the nominee’s full name, dates of service and role.
• Submit the Application Form and Nomination Letter by mail (see reverse) or enter the application
and upload the letter online at www.capcomfcu.org/scholarships.
Deadline for applications: Feb. 19, 2016.
For more information, contact Educational Initiatives at
(518) 458-2195 ext. 4656 or [email protected].
CAP COM and subsidiary employees, volunteers and their families are not eligible.
Federally insured by the NCUA.
2016 Making a Difference Awards
Application Form
Name of student being nominated: ________________________________________________________
Address: ____________________________________________________________________________
City:
_______________________________________________ State: _____ Zip code: ___________
Phone: _________________________ Email: _______________________________________________
School currently attending:_______________________________________ Grade level: _____________
For high school seniors, also note the college they plan to attend:________________________________
Name of person nominating the student: ___________________________________________________
Relationship to student (if not self): ________________________________________________________
Phone: _________________________ Email: _______________________________________________
How did you hear about this award? _______________________________________________________
Verification of Work and/or Community Service (if Applicable)
Organization Name: ________________________________________ Location: ____________________
Brief description of time spent with organization and dates:
_____________________________________________________________________________________
The letter that accompanies this Application Form should be written and signed by a representative at the
organization. It should provide more detail about the nominee and their contributions.
_______________________________ ____________________ __________________________ ______
Name of Organization Representative Title
Signature
Date
Nominations must be received by Feb. 19, 2016. Mail this Application Form along with a
Nomination Letter to:
Educational Initiatives
CAP COM Federal Credit Union
4 Winners Circle
Albany, NY 12205
For more information, contact Educational Initiatives at (518) 458-2195 ext. 4656 or at
[email protected].
CAP COM and subsidiary employees, volunteers and their families are not eligible.