Elyria Police Community Champion Award

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The Elyria Police Department’s Community Champion Award recognizes young people who make a positive difference in our community through their actions, choices, and character. We want to celebrate students who demonstrate kindness, leadership, courage, compassion, perseverance, community service, or simply choose to do the right thing when no one is watching. If you know a young person who is making Elyria a better place, we invite you to tell us their story and nominate them for recognition.

Student information:

Student Name

First

Last

Age

Gender

Male
Female
Other

School

Parent / Guardian Name

First

Last

A parent / guardian will be contacted prior to recognizing the student to obtain permission.

Parent Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent Phone

Please provide specific details, including what happened, when it happened, and how the student made a positive impact.

Nominator information:

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Confirm Email

Relationship to the student

What is the primary reason you are nominating this student?

Is there anything else you would like the selection committee to know about this student?

What else you

May the Elyria Police Department contact you for additional information regarding this nomination?

Disclaimer: The information provided through this nomination form will be collected and used by the Elyria Police Department for the purpose of reviewing and considering nominations for the Elyria Police Community Champion Award.

Nomination information will be shared only with members of the Elyria Police Department and individuals directly involved in the review and selection process, as appropriate. Please do not submit confidential, sensitive, or private information that is not necessary to support the nomination.

By submitting this nomination, you understand that submission of a nomination does not guarantee that the nominee will be selected to receive an award.

If the nominee is selected, the Elyria Police Department may contact the nominator for additional information and/or to coordinate recognition of the student. Any use of the student's name, photograph, or nomination story for public recognition, social media, website, news releases, or other department communications will be subject to appropriate consent and applicable City of Elyria policies and requirements.

The Elyria Police Department reserves the right to verify information provided as part of the nomination and to determine eligibility and award recipients.