Application

Name*
First Last
Email*
Phone*
Zip Code*
First Public Service Activity: Name of organization/public service*
Your role within the organization
Organization Website/Social Media
Start Date and End date
Description of Duties
Second Public Service Activity: Name of organization/public service*
Your role within the organization
Organization Website/Social Media
Start Date and End date
Description of Duties
Third Public Service Activity: Name of organization/public service*
Your role within the organization
Organization Website/Social Media
Start Date and End date
Description of Duties
Please submit an image or videos of your work in action.*
Drop files here or

Max. file size: 50 MB.
Attach a one-page, single-spaced statement that makes a case as to why you should receive the award.*
Drop files here or

Max. file size: 50 MB.
Usage & Permission
*
- By checking this box, I grant Our Bright World, Inc. permission to include my name, school name, and likeness in future communications, including digital and print communications.
*
- By checking this box, I confirm that I have permission/authorization to share media and information about my organization with Our Bright World, Inc. to use on their website.
*All submissions should reflect personal experience and focus on the work you are doing to create effective and sustainable change in your community, region, country, or the world.