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University of Rochester
Warner: Designated Leader Scholarship Nomination Form
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Scholarship nominee information
Candidate's first name
Candidate's last name
Work email
Preferred phone
Why does this nominee have the potential to be an effective school building or district leader?
Nominator information
First name
Last name
Work email
Work phone
School district
Are you the candidate's supervisor?
Are you the candidate's supervisor?
Yes
No
Title
Title
Superintendent
Other
Title
Endorsement
Endorsement
I endorse this nomination and will make a good faith effort to provide an appropriate internship experience for the nominated candidate in the second year of study.
Superintendent approval is required for scholarship consideration. Following your submission, a separate message will be sent to your school system superintendent for endorsement of the nomination. Please alert your superintendent of the scholarship nomination.
Superintendent first name
Superintendent last name
Superintendent email
Submit