(To be submitted by student.)
Before you fill out this form, download THIS CHECKLIST to ensure you are prepared.
Nomination Entry Deadline is April 17, 2020.

Student Information

Enter your information below

Parent(s) / Guardian(s) Info

Enter the information for your parent(s) or Guardian(s).


Enter your information.

SAT Scores

ACT Scores

Scholastic Honors

10th Grade

11th Grade

12th Grade

Sports Accomplishments

Varsity Letters

Check each grade you received a varsity letter.

Sports Honors

Describe any honors or awards you have received as an athlete.

School / Religious / Community Service

Please be descriptive and explain how you serviced your community.

Student Statement

Please answer the following question in 500 words or less.

3 Photos of Student

Upload 3 photos, one class photo, one action photo in the sport of your choice and one fun photo with family, friends or something that exhibits your community involvement..

*If you are unable to upload at this time, please have your nominee email photos to: gregpoehlmann69@yahoo.com

Letters of Recommendation

Upload letters of recommendations from one coach, one teacher and one active community member. (.doc, .jpg, or .pdf)

School Representative Information

Please provide the contact information of your school's representative who will be certifying the information you have entered. They will receive an email with the information you entered and further instructions.

Submit Your Entry

Please read the statement and check the box.

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