Champions of Diversity Award Nominee Information

Note: Fields with a * are required

*First Name:    *Last Name:

Address:  

City:       State:      Zipcode:  

Phone No:     Birthdate M/D/Year: 

High School:       GPA:      Grade in School:  

Please describe how this student has contributed to diversity through leadership and/or community service. (35-50 maximum words.)

Scholarship Nomination

This section should only be filled out if you are nominating a senior for a scholarship. It is not necessary if you are nominating a student just for a Champions of Diversity Award.

I would like to nominate this high school senior for a scholarship from the following school(s):
Skagit Valley College    Western WA. Univ.    Washington State Univ.  
Univ. of Washington   Central WA. Univ.   Eastern WA. Univ.    Evergreen St. College
We recommend that the student submit an admissions application to the college(s) of their choice.

In order to be considered for scholarships, you must complete a letter of recommendation outlining the student's community and academic achievements, academic abilities, educational goals, extra curricular activities, employment, family obligations and other qualities which distinguish the student.

Use the text box below to complete your letter of recommendation. Your letter may be typed in Word, copied, then pasted into the text box below. Recommendation letters must be a minimum of 250 words.

What is the student's major interest?
Early Childhood Education  Education Engineering Human Services

Medical Assistant Nursing Science  Radio/Media Welding

Other: 

Nominator Information

*First Name:      *Last Name: 

Organization:     Title: 

Address: 

City:      State:      Zip Code: 

*Phone No:      email: