21st Annual Gold Circle Partnership Award Application

For the 2008-2009 School Year

Each school can apply for a Gold Circle Award by listing the community partnerships that helped to enhance and enrich the education of their students this year.

There is a $25.00 application fee to submit a Gold Circle Award application regardless of the number of partnerships listed. Applications will not be considered complete until the application fee is received.

You may submit up to 10 partnerships at once on this form by simply following the links. Once you have input ALL your information, click the submit button, and you will be taken to a summary page for you to print, sign and send in with your application fee.

If you have questions about completing the Gold Circle application, please contact Daniel Hebert, Executive Director, by e-mail at dhebert@nhpie.org or by phone at (603) 540-0620.

All online applications and fees must be received no later than June 12, 2009.

SUBMITTING SCHOOL INFORMATION—

School Name:	SAU:
School Contact Name:
Phone Number :	(000) 000-0000
Address:
City / State / Zip:	/ /
Email Address:

PARTNERSHIP #1:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #2:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #3:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #4:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #5:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #6:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #7:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #8:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #9:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

Do you have another partnership to submit? CLICK HERE
If you are finished and ready to submit all the above information,

PARTNERSHIP #10:

Company Name:
Contact Name:
Phone Number :	(000) 000-0000
Email Address:
Address:
City / State / Zip:	/ /
Number of volunteers:
Number of volunteer hours for this partnership:
Type of Partnership:	Instructional volunteer - mentors, tutors, internships sponsor, lunch buddies, workshops Resource person - guest speaker, career day, job shadowing, executive-on-loan Special events sponsor - tours, field trips, assemblies, recognition Other (please specify)

If you are finished and ready to submit all the above information,