Late Nominations | College Prep Program | Washington University in St. Louis

2022 College Prep Program Nomination Form

Nominator Information

Nominator First Name *

Nominator Last Name *

Relationship to Student *

Nominator Email Address *

Contact Phone Number *

Student Information

Student First Name *

Student Last Name *

High School *

Student Email Address *

Please double-check spelling, as College Prep communication updates will be sent by email.

Student Contact Phone Number *

Parent Email Address *

Parent Contact Phone Number *

Will this student be a first generation college student (neither parent/guardian has received a bachelor’s degree)? *

Yes

Unsure

How would you rank this student’s academic performance compared to others in their grade? * How would you rank this student’s academic performance compared to others in their grade?

How long have you known this student and in what capacity? How do you think they would contribute to and benefit from this three-year college preparation experience? (please describe in at least 100 words) *

Electronic Signature *

I confirm that the information contained in this nomination form is true. My electronic signature is the legal equivalent of my actual signature on this form.

Date *

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