one by one we make a difference




Statement of Purpose:

The Louise Russo Youth Awards recognize youth who exemplify “the 3R‘s”
Respect, Responsibility and the Role of leadership
They do this through initiatives that reduce violence and create positive changes in their school community.

Applicant Requirements:

  • Must be grade 7 to 12.
  • Presently enrolled in an Elementary or Secondary School Program.
  • This application must only be filled out by the candidate applying for the award and not an adult.


Applicant Information
Date of Birth:*
Home Address:*
Home Phone Number: *

School Information
School/Programme Attending:*
School/Programme Address: *
Grade Level or Equivalent: *

Support/Reference Letters:

Please ensure you enclose your two support/reference letters with your submission. Below, please list the two individuals who provided you with support/reference letters.

Please note: Support/reference letters should give examples of how the applicant reflects the Award's statement of purpose and values.
Support / Reference Letters #1
#1 Name:*
#1 Relationship:*
#1 Contact No.:*
#1 Organization:*
E-mail Address: *
Support Letter - Upload here #1*

Support / Reference Letters #2

#2 Name:*
#2 Relationship:*
#2 Organization:*
#2 Contact No.:*
E-mail Address:*
Support Letter - Upload here #2*

Application Questions:
1. Please list what you have done in the last 1 to 5 years to merit the Louise Russo Youth Award?*
2. How do you see your contribution and/or accomplishments continued in the future?*

3. Exemplify “the 3R’s” – Respect, Responsibility and the Role of leadership and how your program and/or actions have affected your school and/or community:

a. Respect:
a. 1)*
a. 2)*
a. 3)*

b. Responsibility:
b. 1)*
b. 2)*
b. 3)*

c. Role of Leadership:
c. 1)*
c. 2)*
c. 3)*
4. How have your actions made a difference in your school and/or your community?*

5. Please submit on a 250 word essay on “what inspires me to believe that one by one we can make a difference” and upload it here.
Upload here:*


I certify that the information provided on this application form is true and accurate. All information on this application will be kept confidential and on file by Louise Russo W.A.V.E. (Working Against Violence Everyday).

If my application is selected for an award, I authorize my name, photo and award details to be publicized. Finally, I understand that I am required to attend the W.A.V.E. Empowering Youth Day on Wednesday May 10, 2017 at the Living Arts Centre in Mississauga, Ontario. I agree that I will make the necessary adjustments to my schedule to ensure that I will be able to attend this one-day ceremony.


Parental/Guardian Endorsement:

Parent/Guardian/School Official endorsement required if student is under 18 years of age

I endorse this application and verify the information:

Parental/Guardian Name:*
Contact No.: *
Endorsement Date:*


Deadline for Submission:

Completed applications and supporting material must be received by:
Friday March 10, 2017



  • Submit online
  • Email to
  • Mail (Please note courier is not accepted at the P.O. Box)

Louise Russo W.A.V.E. (Working Against Violence Everyday)
P.O. Box 60791
RPO Jane Wilson North York, Ontario M3L 2N5
Registered Charitable #84950 2950 RR0001

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