PRIDE Nomination Form.

Return to:

FAX:

Age:

Grade Level:

Name and Address of School:

School District:

Description of why child is being nominated for PRIDE: (attach additional pages if necessary):

Does the child have family transportation to get to an event?     Yes.        No.

Signature and date (Principal):

Signature and date (Teacher):

PRIDE is sponsored by the KU Children’s Center – a non-profit organization – at the University of Kansas Medical Center.