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CAPE CORAL POLICE DEPARTMENT'S "DO THE RIGHT THING" PROGRAM Help us find students who have done "the right thing."

Each month of the school year, the Cape Coral Police Department honors young people in our community who distinguish themselves by their exemplary actions.

If you know a student (K-12) whose accomplishments, attitude, or outstanding effort makes them a positive role model for their peers, please complete this form and mail or fax it to:

DO THE RIGHT THING PROGRAM Cape Coral Police Department

P.O. Box 150027, Cape Coral , FL 33915 Phone (239) 242-3342 Fax (239) 573-3046

cnaumann@capecoral.net

NOMINATION FORM

Name of Student: _____________________________

Parentsnames: ___________________________________________________________

Child 's full address: ____________________________________

City, State, ZIP: ________________________________________________

Grade in school: Name of School : __________________

T-shirt size: (adult sizes) Small Medium Large__ XL

Your name: Your phone number: _________

Your address: Your e-mail :

Date the event occurred if applicable: ____________

Do you know a student who ...

• helps an older neighbor with chores?

• writes letters to military personnel?

• picks up litter on the beach?

• visits the children 's ward at the hospital?

• helps a new classmate who is having a hard time?

• collects toys for underprivileged chil­dren?

• teaches safety to younger children?

• shows concern for wildlife?

• acted quickly in an emergency?

• mows the lawn at church?

• has taken on a cause which he/she feels strongly about?

• took the time to learn someone else's culture

• earns money or gives of themselves for a worthy cause?

• Serves as a role model for others? Explain why you feel that this student should be honored: (please give as much detail as possible)