Envision 2022 Student Nomination Form

2022 Summer Internship Nomination Form
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
Our dedicated sponsors have once again made it possible for us to offer unparalleled scholarship assistance in 2022.

The Future Leaders Scholarship grants recipients attending our Georgetown Summits receive one-on-one college application assistance from top admissions experts, tuition remittance of one-third of the program's cost ($1000) and unlimited college essays or scholarship applications professionally reviewed by our partners at University Connections.
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
Thank you for filling out this form, we could not transform lives without your assistance. You will be cc'd on emails going out to students you recommend to our program. All nominations will be reviewed within 72hrs.
Should be Empty:

2022 Summer Internship Nomination Form

Student Scholarship Nomination Information