Convergence Nominator Form 2019
Do you know a youth who would enjoy a 9-day faith and science immersion experience? Please submit the form below to nominate a rising high school sophomore, junior, or senior to join us at Convergence: A High School Youth Theology Institute at Randolph-Macon College in Ashland, Virginia. This year’s event will be held June 22-June 30, 2019. To learn more, please visit our website: convergence.rmc.edu.

Once your form has been submitted, we will contact the student to let them know they have been nominated and encourage them to apply for our program. Please feel free to nominate as many potential participants as you would like, but we ask that you do so on separate forms.

Students accepted to our program will have the opportunity to come to Randolph-Macon College to learn about faith, science, and where they converge in our lives. In our society, these two topics are often portrayed in contrast; at Convergence, we know that faith and science can connect in many meaningful ways. Students will participate in science and faith based lectures, hands-on science activities, and several excursions where faith and science come together.
The cost to participate is only $250 per student, including room and board costs and all other Institute-related expenses for nine days. Need-based scholarships are available.

If you have any questions regarding this form, the application process, or the Convergence program, please contact Program Coordinator Laura Ruxton (804.752.8712 or convergence@rmc.edu).

Your name *
Your answer
Your email address
Your answer
Your mailing address *
Your answer
Your phone number *
Your answer
What best describes your role in the life of the students you are nominating? *
Are you connected to a faith community? If so, please provide the name, mailing address, and phone number: *
Your answer
Would you like your nomination to remain anonymous? *
Name of student *
Your answer
Mailing address of student
Your answer
Email address of student *
Your answer
Phone number of student
Your answer
Email address of Parent/Guardian: *
Your answer
Student's current grade level *
Your answer
Student's current school
Your answer
Name of student's faith community: *
Your answer
Why would you recommend this student for the Convergence Youth Theology institute? *
Your answer
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