High School Scholar Award Nomination Form for Deaf and Hard-of-Hearing Students

School Information

High School Name

Street

City

State

Zip

Contact Information

First Name

Last Name

Job Title

Phone

Award Date (if planned) (MM/DD/YYYY):

Student Nominees

High schools may nominate two deaf or hard-of-hearing students for each of these two awards (Technology Scholar Award and Creative Scholar Award). Please adhere to the nomination qualifications as closely as possible.

RIT/NTID Technology Scholar Award

Technology Scholar Nominee #1

Yes

Do you have a first technology scholar nominee?

Technology Scholar Nominee #1 Information

First Name

Last Name

Phone

Street

City

State

Zip

Date of Birth (MM/DD/YYYY)

Cumulative GPA

Leadership positions in school or community

Demonstrated ability and interest in technology

Additional comments (optional)

Technology Scholar Nominee #2

Yes

Do you have a second technology scholar nominee?

Technology Scholar Nominee #2 Information

First Name

Last Name

Phone

Street

City

State

Zip

Date of Birth (MM/DD/YYYY)

Cumulative GPA

Leadership positions in school or community

Demonstrated ability and interest in technology

Additional comments (optional)

RIT/NTID Creative Scholar Award

Creative Scholar Nominee #1

Yes

Do you have a first creative scholar nominee?

Creative Scholar Nominee #1 Information

First Name

Last Name

Phone

Street

City

State

Zip

Date of Birth (MM/DD/YYYY)

Cumulative GPA

Leadership positions in school or community

Demonstrated achievement in innovation, creativity or entrepreneurship

Additional comments (optional)

Creative Scholar Nominee #2

Yes

Do you have a second creative scholar nominee?

Creative Scholar Nominee #2 Information

First Name

Last Name

Phone

Street

City

State

Zip

Date of Birth (MM/DD/YYYY)

Cumulative GPA

Leadership positions in school or community

Demonstrated achievement in innovation, creativity or entrepreneurship

Additional comments (optional)

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