Scholarship Nomination Form
No self-nominations and no nominations by family members.
Waverly Student Nominating:
First Name
Last Name
GPA:
Nominator Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Nominator Email
example@example.com
Nominator Phone
Please enter a valid phone number.
Relationship to Student
Title
Please describe the student’s service to their community (WHS, Waverly Community, Greater Lansing Area & the Global Community). Please indicate whether the service was part of a Waverly program or an out-of-school involvement:
Please indicate which High School years the student was involved in the service:
Student’s future plans for education:
If awarded the Scholarship, the student also gets to select a WHS organization to receive a matching grant, which WHS Organization would the student like to receive.
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Submit
Should be Empty: