One World SurgerY High School Scholarship

Youth Hockey Hub Summit Service Award

Please complete the form below to apply or to nominate an outstanding individual for the YHH Summit Service Award. Mission trip dates are August 2-9, 2025. Students must be available the entire week of the mission to be eligible. Nominations must be submitted by February 1, 2025.
Nominee Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
Age (If DOB unknown)*
Nominee must be 16 by August 3, 2025
Student Phone Number*
Parent/Guardian Cell Phone Number*
Nominator Name*

First NameLast Name
Nominator e-mail*
Enter E-mail Here
Parent/Guardian Name*

First NameLast Name
Parent Guardian e-mail*
Enter E-mail Here
Parent/Guardian Address

Street Address

Apt/Unit #

CityState

Zip Code
School Currently Attending*
Hockey Level for 2024/2025 Season*
Which Team Does Nominee play on?*
Briefly describe the nominee's personal traits (such as leadership, enthusiasm, reliability, creativity, and initiative) that would make them a great candidate for the YHH Summit Service Award *

0/600
How has the nominee demonstrated service to their community or team? Please list specific actions or events they have participated in, and the roles taken. *

0/600
How has the nominee supported an environment of collaboration andinclusiveness within their community or team?*

0/600
In what other ways has this nominee contributed to their community or team? What else do we need to know about the nominee’s character? *

0/600
Why does this nominee want to continue to grow their aptitude for serving others by joining a medical mission trip?*

0/600
Does the nominee have a current passport? Please note, a current passport is required to be eligible for the YHH Summit Service Award.*
U.S. passport holders
Honduras: Passport must be valid for 6 months past date of entry into Honduras. A visa is not required for a stay in Honduras up to 90 days.
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Youth Hockey Hub Summit Service Award