Scholarship Nomination

School

Head Coach

Email

Phone

Address

Address 2

City

Student Athlete Nominee

What is their cumulative GPA?

Are they a high school senior?

Yes

No

Will they graduate at the end of the current school year?

Yes

No

Which of the following will they be attending after graduation?

Two Year College

Four Year College

Trade or Technical School

State Recognized License

Are they in good disciplinary standing with their school district?

Yes

No