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Champions of Diversity Nomination Form

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    Skagit Valley College in partnership with Central Washington University, Eastern Washington University, The Evergreen State College, North Cascades Institute, University of Washington Bothell, University of Washington Seattle, Washington State University, and Western Washington University seeks nominations for 9th - 12th grade students from Skagit, Island and San Juan County high schools who have contributed to diversity on their campuses and in their communities. Nominated seniors will be considered for scholarships offered by colleges throughout the state. Nominations are due by 5:00pm on Friday, October 14, 2011.  Selected students will be honored November 30, 2011 at the Champions of Diversity Awards Ceremony to be held in McIntyre Hall, Skagit Valley College, Mount Vernon, WA.

    If you have any questions about the nomination form or process, please contact Drew Winsor, dwinsor@skagit.edu at: 360.416.7838.

    Note: Use the Tab button to move to the next form field.


    Page 1 of 3 (Award Nomination) Page 1 of 7 (Scholarship Nomination)

    Nomination Principles for COD Awards

    In order to nominate your student for the Champions of Diversity Award and/or Scholarship, you must read over and confirm your understanding of the following-

    1. Maximum number of nominations: each nominator may nominate five students, including a maximum of three scholarship nominations.
    2. Please link to and read the following: http://www.skagit.edu/news3.asp_Q_pagenumber_E_1712 

    I have read and understand the Nominating Principles for COD Awards and/or Scholarships   Date:

    Page 2 of 3 (Award Nomination) Page 2 of 7 (Scholarship Nomination)

    Nominator Contact Information

    First Name: Last Name:
    Organization: Title:
    Address: City:
    State: Zip:
    Phone Number: () Email:
    Phone Extension:

    Are you nominating a Senior for a scholarship? (No = Proceed with the three page award nomination form, Yes = Proceed with seven page scholarship nomination form)

    Page 3 of 3 (Award Nomination)

    Champions of Diversity Award Nominee Information

    First Name: Last Name:
    Address: City:
    State: Zip:
    Cell Phone Number: () Birthdate:
    Home or Family Phone: () High School:
    Grade in School: GPA:


    Please describe how this student has contributed to diversity through leadership and/or community service. (40 words minimum.) Please also briefly summarize what the nominee would like to study. This text will be used as the script for awarded students on the night of the event.

    Character Count (600 characters maximum):

    If the information below looks correct, please click submit button at the bottom of this page. If you'd like to make a change please use the back button to go back and make changes.

    Page 3 of 7 (Scholarship Nomination)

    Scholarship Nomination Strategies

    In order to nominate a senior for the Champions of Diversity Scholarship, you must read over and confirm your understanding of the following -

    Scholarship Guidelines

    • Please limit your scholarship nominations to three students.
    • Make sure the student meets the minimum 2.0 GPA if you are nominating for a scholarship.
    • Scholarships to each college are limited.  Therefore, always mark all schools that your student would consider attending keeping in mind what is offered at the college or university of choice.

    What are the Universities and SVC looking for in a scholarship nominee?

    • Demonstrating a commitment to community service and leadership
    • Demonstrating cultural awareness or unique perspectives or experiences
    • Demonstrating notable tenacity, insight, originality or creativity
    • 1st generation college student (neither parent has a 4 year college degree)
    • Exercising significant responsibility in a family, a community, employment or through activities
    • Attaining a college prep education in the face of significant personal adversity, economic disadvantage (free or reduced lunch) or disability

    I have read and understand the Scholarship Nomination Strategies:   Date:

    Page 4 of 7 (Scholarship Nomination)

    Champions of Diversity Award Nominee Information

    First Name: Last Name:
    Address: City:
    State: Zip:
    Cell Phone Number: () Birthdate:
    Home or Family Phone: () High School:
    GPA:


    Please describe how this student has contributed to diversity through leadership and/or community service. (40 words minimum.) Please also briefly summarize what the nominee would like to study. This text will be used as the script for awarded students on the night of the event.

    Character Count (600 characters maximum):

    Page 5 of 7 (Scholarship Nomination)

    I would like to nominate this high school senior for a scholarship from the following schools:

    Central Washington Univ
    Eastern Washington Univ
    The Evergreen State College
    Skagit Valley College
    Univ of Washington, Bothell
    Univ of Washington, Seattle
    Washington State Univ
    Western Washington Univ

    We recommend that the student submit admissions' applications to the colleges of their choice.

    Page 6 of 7 (Scholarship Nomination)

    Student is not interested in attending Skagit Valley College

    Student has interest in attending SVC and would like to be considered for a scholarship in one or more of the following areas (check those you are interested in): 

           Allied Health
           Automotive Tech.
           Early Childhood Education
           Pre-Engineering
           Human Services
           Medical Assistant
           Nursing
           Science
           Radio/Media
           Welding

    Student is interested in attending SVC, but not in any of the areas below

    Page 7 of 7 (Scholarship Nomination)

    For your nominee to be considered for scholarships, you must fill in the following four text boxes, clarifying why your nominee is a Champion of Diversity. We suggest you compose your responses in a separate document, and then copy and paste into the text boxes below. Each text box holdes a maximum of 1,000 characters, or about 170 words (one character equals one space or letter). Please tell us about:

    Student's life story


    Character Count (1000 characters maximum):

    Obstacles/challenges they have faced in their life


    Character Count (1000 characters maximum):

    Service/Leadership they have shown at home, in their community, or at school


    Character Count (1000 characters maximum):

    The diversity component(s) in their life


    Character Count (1000 characters maximum):

     

    If the information below looks correct, please click the submit button at the bottom of this page. If you'd like to make a change please use the back button to go back and make changes.
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