2019 Academic All-Stars/Gathering of Champions Nomination Form

Each student nominated as an Academic All-Star is invited to participate in one of the recognition ceremonies held as part of the Gathering of Champions statewide celebration on Friday, August 2 at the Mall of America from 9 a.m. to 6 p.m.

The nomination form below will allow you to fill in your contact information once, and then enter one or more names of the students you wish to nominate in the last text box. You may add additional names at a later time by returning to this site, but you will then be required to fill in the informational fields about yourself and your school again in order to submit more names.

If you have any questions or need assistance, please email Synergy & Leadership Exchange: goc@synergyexchange.org.

Confirmation will be sent to the email address provided below, please type carefully.

Email address *
Your first name (nominator): *
Your answer
Your last name (nominator): *
Your answer
Your daytime phone number: *
Your answer
School district name: *
Type "none" if nonpublic or independent school.
Your answer
School name: *
Your answer
School street address: *
Your answer
School city: *
Your answer
School zip code: *
Your answer
School county: *
Your answer
School principal/administrator name: *
Your answer
School phone number: *
Your answer
List of student names: *
Please list the student’s first name and last name followed by a comma to separate the names in your list (example: John Doe, Jane Doe). Use proper capitalization, and please do not include GPAs, grades or reason for nomination. Separate student names with commas only – please do not use “and” between students. For your convenience, if you have prepared the list of students’ names in a word processing document or spreadsheet, you may copy that list and paste it in the text box.
Your answer
Number of students nominated: *
Please indicate the number of students you are nominating so we can confirm we received all the names.
Your answer
A copy of your responses will be emailed to the address you provided.
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