York Suburban Communities That Care Alliance

Cathy Shaffer Award of Honor

2009 Nomination Form

York Suburban Communities That Care Alliance strives to provide research-

based tools to help our community promote the positive development of
children and youth, prevent adolescent substance abuse, and reduce youth
violence. Cathy Shaffer was instrumental in the formation of YS CTC Alliance
and served as the first president of the Board of Directors. Her dedication and
commitment led this organization to a position that has allowed us to touch
many lives within the York Suburban community.

YS CTC seeks to honor these efforts by honoring students who, through their
actions and words, demonstrate and promote the values of YS CTC Alliance.
Awards will be presented at the Middle School and High School awards
ceremonies. The following shall be the criteria upon which nominations will be
judged:
A nominee shall
• promote the values of YS Communities That Care
• be a strong role model
• be involved in the community
• be a student in grades 6-12
• be a resident of York Suburban School District

Do you know a student who is making this kind

of positive contribution to our community?
Nominee’s
Name_______________________________________________________________________
Address ________________________________________________________________________
Phone # ____________________ Grade _____________
Nominator’s Name
_____________________________________________________________________
Address ________________________________________________________________________
Phone # ____________________ Relationship to Nominee
______________________________
Please explain clearly, in detail, how this student has demonstrated
the values of YS CTC and has acted as a strong role model for others in our
community. Use the reverse side or additional sheet as necessary to give a
complete description.
All nominations MUST be received by April 15, 2009. Please return this form to:
Shama Mir
YS CTC Alliance
1800 Hollywood Drive
York, PA 17403

York Suburban Communities That Care Alliance connects families and youth
with effective resources that promote responsible decision-making and reduce
destructive behaviors.