2013-14 Teacher Nomination Form

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Thank you for your interest in nominating students for the EMERGE-HISD program. We are looking for students in grades 9, 10, and 11 that are in the top 10% of their class who are driven, possess high academic ability, and have the motivation to attend a top-tier university.

Each teacher may nominate up to 5 students for the EMERGE-HISD program. Nominations will be used to recruit students to apply to the program and will additionally be considered during the application process. Please note that a nomination does not guarantee a student a place in the EMERGE-HISD program - nor does it exempt a student from applying. Each student must also fill out an application in order to be considered.

Teacher Name *

First and Last

High School *

Student Name *

First and Last

Student ID Number *

Student High School *

Student Grade Level *

Please note we are no longer accepting seniors this year.

9th

10th

11th

Optional: Please include 2-3 sentences about this student's academic ability, extracurricular involvement, or anything else you believe makes the student a good fit for the program.

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