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SUPPORTERS
High School Scholarship Registration 2020
*
Nominating Teacher: Name (Last/Family name, First/Given name)
example: Jackson, Michael
*
Nominating Teacher: Phone number
312-777-1234
*
Nominating Teacher: email address
example:
[email protected]
*
School name
example: Whitney Young Magnet School
*
School: Street Address
example 3745 W. Addison St.
*
School: City
example: Chicago
*
School: State
Illinois or Indiana
--Please select--
IL
IN
*
School: ZIP code
example: 60134
*
Student #1: Last/Family name
example: Chavez
Student:#1: first name
Example: Gwen
*
Student #1: Home street address
example: 1245 E. North Ave., Apartment 314
*
Student #1: Home city
example: Chicago
*
Student #1: Home state
Illinois or Indiana
--Please select--
IL
IN
*
Student #1: Home ZIP code
example: 60016
Student #1 email address
[email protected]
*
Student #1: Year in school
--Please select--
9th grade
10th grade
11th grade
12th grade
Student #2: Last/Family Name
example: Nguyen
Student #2: First name
Example: Gwen
Student #2: Home Street Address
example: 7743 W 57th St., Unit 3A
Student #2: Home City
Flossmoor
Student #2: Home State
Illinois or Indiana
--Please select--
IL
IN
Student #2: Home ZIP code
example: 60068
Student #2 email address
[email protected]
Student #2: Year in school
--Please select--
9th grade
10th grade
11th grade
12th grade