THE CHARLES SCHOLARSHIP PROGRAM

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SCHOOL NOMINATION FORM

Each high school may nominate up to three students.

Instructions for Counselors

Required fields indicated with *.

Nominee Ethnic Background (Optional)

Does the student self identify as Hispanic?
Ethnicity (select all that apply)
Nominee Birthdate*



Nominee GPA & Class Rank

Nominee Course Rigor

Please select the caliber of this student's academic program in the context of the course offerings in your curriculum.

Supporting Documents

Please check the boxes to indicate these documents have been uploaded.* If the required transcript and recommendation letter are not uploaded, the nomination will remain incomplete and will not move forward.

School and Nominating Representative Information

School Endorsement

Please provide the information below for the school official (principal/headmaster, vice principal, or guidance chair) certifying your school's endorsement of this nominee.