Convergence Nominator Form 2021
Do you know a youth who would enjoy a 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 21st & 22nd, June 28th & 29th, July 7th, and/or July 25th – 28th, 2021, virtually. To learn more, please visit our website:

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 sessions and activities where faith and science come together.
The cost to participate per student for each session is listed at, including all Institute-related expenses for each session. Need-based scholarships are available.

If you have any questions regarding this form, the application process, or the Convergence program, please contact Convergence Co-Director Rev. Kendra Grimes (804.752.7374 or
Your name *
Your email address
Your mailing address *
Your phone number *
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: *
Would you like your nomination to remain anonymous? *
Name of student *
Mailing address of student
Email address of student *
Phone number of student
Email address of Parent/Guardian: *
Student's current grade level *
Student's current school
Name of student's faith community: *
Why would you recommend this student for the Convergence Youth Theology institute? *
Never submit passwords through Google Forms.
This form was created inside of UVa. Report Abuse