Counselor Nomination Form - Jenkins Scholar

    Open only to U.S. citizens who are residents of Alabama, Florida, Georgia, North Carolina, South Carolina, Tennessee, or Virginia, graduating from an accredited high school within their home state.
    Counselor and High School Information
    High School Address
    High School Address
    Nominated Student Information
    Nominated Student's Date of Birth
    Nominated Student's Date of Birth
    Signature