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BCSN & BELLE TIRE GIVE BACK ENTRY FORM

Organization/Group/Team Information
Organization/Group or Team Name:
*
School Name:
*
School Address:
*
City:
*
State:
*
Zip:
*
Phone #:
*
Tell us why your school organization/group/team deserves the ‘Give Back’ award and specifically how the money will be used.
(200 words or less)
Person Submitting Nomination Form Information
Your Name:
*
Phone #:
*
Email:
*
 

*All Required Fields

RULES: The BCSN & Belle Tire Give Back program offers organizations within Elementary, Junior High, and High Schools (Kindergarten through 12th grade) in the Buckeye CableSystem Toledo service area a chance to win a monthly cash award donated by Belle Tire. The award will help with a worthwhile improvement for the school, school organization, or school sports team. It can include new uniforms, field trips, musical equipment, computers, etc.

Schools, school organizations, school sports teams, or school representative (including students) can nominate themselves by writing an essay (200 words or less) on why their school, organization, or team deserves the one-time cash award. Nomination forms can be obtained through BCSN’s website (BCSN.tv), at any Toledo area Belle Tire location, or the BCSN administrative office (115 S. Reynolds Rd, Toledo, OH 43615). Completed nomination forms will be accepted by mail or dropped at Buckeye CableSystem (see address below) beginning August 15, 2011 through May 10, 2012. If a school, school organization, or school team is not chosen as the monthly winner, schools may re-apply in the subsequent months.

Each month, September through June, five nominees will be chosen as finalists at BCSN’s discretion. The five finalists will be placed in a voting poll on BCSN’s website (BCSN.tv). Viewers will vote on the finalists, and the finalist earning the most votes will be named the month’s winner. The monthly winner will receive a one-time $500 cash award donated by Belle Tire. The award will be given to the school that submitted the original nomination form. The winner will be announced through a promotional commercial produced by Buckeye CableSystem that will air in the month the winner is chosen. The winner will be contacted by Buckeye CableSystem for telephone and/or camera interviews. Winners may only receive one monthly award within one program year (September to June).


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