2014 Youth Leadership Institute Nominator Form
2014 Youth Leadership Institute Nominator Form About the Youth Leadership Institute: The Youth Leadership Institute (YLI) is a three-day, overnight college empowerment conference for Hispanic high school juniors designed to give students the practical tools they need to successfully apply to top universities, effectively access financial aid and scholarship opportunities, and excel in school and beyond. Cost: The program is free of charge. HSF also provides local transportation for some students. Locations and Dates:
Los Angeles, CA: Loyola Marymount University (June 12 – June 14) Dallas, TX: The University of Texas at Dallas (July 10 – July 12) Albuquerque, NM: The University of New Mexico (July 17 – July 19) Greater Washington, DC: Marymount University (July 31 – August 2) Silicon Valley, CA: Santa Clara University (August 7 – August 9)
Student Qualifications: High School Class of 2015 (current high school juniors) 3.0 GPA or above on a 4.0 scale Identify as being of Hispanic heritage Nomination Process: The Hispanic Scholarship Fund is seeking outstanding junior applicants to participate in the 2014 YLI programs. Please nominate up to 5 male and 5 female candidates who display leadership in your campus community and maintain at least a 3.0 cumulative GPA. Students may be nominated by a parent, principal, guidance counselor, teacher or other professional in the field of education. PLEASE NOTE: Students DO NOT have to be nominated to apply. The forms you will need to nominate are provided below. Step 1: Complete the Nominator Information form. Step 2: Complete the Nominee List by entering the full information for each of your qualified candidates, as designated, in the tables below. Step 3: Return the Nominator Information form electronically to Bianca Ojeda at [email protected], or via fax at 310.349.3328, before Friday, April 30, 2014. Step 4: Each of your candidates will be contacted and instructed to complete his/her YLI application before Monday, May 9, 2014.
Nominator Information Nominator Name (Required) First Name:
Middle Initial:
Last Name:
Occupation or Title (Required):
Employer (Required):
Address or P.O. Box (Required):
City:
State:
Zip Code:
E-mail Address (Required):
Alternate E-mail Address:
Telephone Number (Required):
Alternate Telephone Number:
Nominator’s Relationship to Nominees (Required) School Principal Teacher Guidance Counselor Other Professional Educator:_______________________
Nominee Eligibility Information Do the Nominees have cumulative GPAs of 3.0 or above on a scale of 4.0? Yes No Are the Nominees members of the class of 2015 (current junior status)? Yes No Do the students identify as being of Hispanic Heritage? Yes No
Nominee List Male Student Nominee Information
1. 2. 3. 4. 5.
First Name
Last Name
Email
Phone Number
Grade Level
GPA
Email
Phone Number
Grade Level
GPA
Female Student Nominee Information
1. 2. 3. 4. 5.
First Name
Last Name
Los Angeles, CA: Loyola Marymount University (June 12 – June 14) Dallas, TX: The University of Texas at Dallas (July 10 – July 12) Albuquerque, NM: The University of New Mexico (July 17 – July 19) Greater Washington, DC: Marymount University (July 31 – August 2) Silicon Valley, CA: Santa Clara University (August 7 – August 9)
Student Qualifications: High School Class of 2015 (current high school juniors) 3.0 GPA or above on a 4.0 scale Identify as being of Hispanic heritage Nomination Process: The Hispanic Scholarship Fund is seeking outstanding junior applicants to participate in the 2014 YLI programs. Please nominate up to 5 male and 5 female candidates who display leadership in your campus community and maintain at least a 3.0 cumulative GPA. Students may be nominated by a parent, principal, guidance counselor, teacher or other professional in the field of education. PLEASE NOTE: Students DO NOT have to be nominated to apply. The forms you will need to nominate are provided below. Step 1: Complete the Nominator Information form. Step 2: Complete the Nominee List by entering the full information for each of your qualified candidates, as designated, in the tables below. Step 3: Return the Nominator Information form electronically to Bianca Ojeda at [email protected], or via fax at 310.349.3328, before Friday, April 30, 2014. Step 4: Each of your candidates will be contacted and instructed to complete his/her YLI application before Monday, May 9, 2014.
Nominator Information Nominator Name (Required) First Name:
Middle Initial:
Last Name:
Occupation or Title (Required):
Employer (Required):
Address or P.O. Box (Required):
City:
State:
Zip Code:
E-mail Address (Required):
Alternate E-mail Address:
Telephone Number (Required):
Alternate Telephone Number:
Nominator’s Relationship to Nominees (Required) School Principal Teacher Guidance Counselor Other Professional Educator:_______________________
Nominee Eligibility Information Do the Nominees have cumulative GPAs of 3.0 or above on a scale of 4.0? Yes No Are the Nominees members of the class of 2015 (current junior status)? Yes No Do the students identify as being of Hispanic Heritage? Yes No
Nominee List Male Student Nominee Information
1. 2. 3. 4. 5.
First Name
Last Name
Phone Number
Grade Level
GPA
Phone Number
Grade Level
GPA
Female Student Nominee Information
1. 2. 3. 4. 5.
First Name
Last Name
