Nominate

Do you work with a resilient child who has big dreams?

Do you work with a child who is economically disadvantaged and has endured one or more adverse childhood experiences? A resilient child who continues to reach for his or her dreams even after continually confronting barrier after barrier? Help bring joy and hope by nominating this child for a Dream experience.

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Summary

Our nomination form is quick and easy to complete and can be saved for link sharing with the parent or guardian.

Criteria for nomination:

  • 1. The nominee must be referred by a professional or non-relative adult nominator. This can include school personnel, child-serving agencies, counselors, coaches, mentors, etc.
  • 2. The nominee must be between the ages of 5-18 on the date the form is submitted. Please note: parent or guardian permission is required for any nominated youth under age 18.
  • 3. The nominee must be disadvantaged economically (up to 250% of federal poverty guidelines) and have had an adverse childhood experience or trauma. Examples of trauma include, but are not limited to:
  • -Grief/loss of loved one
  • -Forced displacement or homelessness
  • -Physical abuse or neglect
  • -Sexual abuse
  • -Child of incarcerated parent
  • -Witness or survivor of domestic violence
  • -Witness or survivor of school or community violence
  • -Military related trauma / deployed caregiver
  • -Emotional abuse/psychological maltreatment
  • -Natural disaster
  • -Non-parental custody
  • -Serious accident
  • -Assault
  • -Extreme poverty
  • -War/terrorism/political violence
  • -Other
  • 4. The nominee must be recognized by the nominator to have positive character traits and motivation to reach for their dreams.
  • 5. The nominee must live in one of the following counties:

Ready to start the nomination process?

Nominator and Dreamer (with Parent/Guardian) complete the form together. **RECOMMENDED**
Download the Nomination Form to complete a hard copy of the paperwork, or complete it online.

Nominator and Dreamer (with Parent/Guardian) complete the form separately.
The nominator can complete the first page of the Digital Nomination Form, save and continue –   ignore the prompt to email the link. From here, they’ll send the email link to the Dreamer’s parent/guardian to complete their portion. The parent/guardian has 30 days to complete their portion. If a nominator prefers a hard copy, you can also download the form, print it, and complete the nominator page only. Then send the rest of the forms to the Dreamer’s parent/guardian to complete and send in separately.

If the dreamer is in CPS custody, the CPS Custody Nomination form link below needs to be signed by the Legal Guardian/CPS worker.
The CPS Custody Nomination Form needs to be signed by the Legal Guardian/CPS worker. If the nominator is different from the Dreamer’s CPS worker, they can send this paperwork directly to the CPS worker to complete. Upon submission of the form, the Dreamer’s form will be provided by Believe in Dreams to the foster parents to help the child complete their dream requests.

Digital Nomination
Download Nomination Form
Download CPS Custody Nomination Form
Download Participants-18 years of age

Questions? Contact us at: 440-484-2376 or email kristen@believeindreams.org