2021-2022 Student Nomination Form

2022 Summer Internship Nomination Form

Please complete this form to nominate students for the Leadership Initiatives virtual Youth Development Programs. Nominations are reviewed within 72 hours and sent out via email. Nominators will be cc'ed on the email.
Nominator First Name*
Nominator Last Name*
Nominator Email Address*
Note: Leadership Initiatives requests your email to confirm receipt of your student nominations and to keep you aware of future nomination opportunities. Your personal information and that of your nominees is stored securely and never shared. We have worked with students from across the globe for more than 15 years, and we maintain a strict, comprehensive privacy policy.
Preferred Phone (Not Required):
How did you hear about our programs?*
If you selected other please indicate how you heard about us*
Institution Name (if applicable)
Student Scholarship Nomination Information
Nominated students receive a $1,000 scholarship to attend the virtual Youth Development Program of their choice and automatic acceptance into our year-round International Internship Program.

All nominated students who enroll also receive academic benefits to ensure they successfully navigate the changing college admissions process. Participants meet one-on-one with admissions counselors, receive one year of standardized test prep from our partners at TestRocker, and receive college assistance from University Connection with college probability modeling, unlimited application essay editing, scholarship assistance, resume editing, and full application review.
Student First Name*
Student Last Name*
Student Email*
Student Graduation Year
Student Phone Number
Would You Like To Nominate Another Student?

YesNo
Student First Name*
Student Last Name*
Student Email*
Student Graduation Year
Student Phone Number
Would You Like To Nominate Another Student?

YesNo
Should be Empty:

2022 Summer Internship Nomination Form

Student Scholarship Nomination Information