Nominee Name (First and Last)* The purpose of the first section of this form is to collect information about the person being nominated. If you are nominating someone other than yourself, you will be asked to include your contact information at the end of this form. Age* Phone number* Email address* Mailing address* Employment Race Ethnicity Gender Why are you nominating this person (or yourself) for this scholarship?*Do you know if this person will be able to participate in the weekend?* Yes No I think so, but I’m not sure Does this nominee know he/she/they are being nominated?* Yes – because I’m nominating myself Yes – I told this person I’m nominating him/her/them No If answer to the previous question was "No", please explain.*Contact Information for Nominator: Name (First and Last)* If nominee and nominator are the same person, after filling in your name here, you may skip to the last question on this form and submit. Nominator Phone Nominator Email Nominator Address What is the best way to contact you?*