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Young Presbyterian Scholars Program Nomination Form
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Student Information
Title:
Mr.
Mrs.
Ms.
Legal First Name
Middle Name
Legal Last Name
Suffix:
Jr.
Sr.
I
II
III
IV
V
VI
VII
VIII
IX
X
Preferred Nick Name
Birthdate (if known)
Birthdate (if known)
January
February
March
April
May
June
July
August
September
October
November
December
1
2
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1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Student Email
Cell Phone Number
Home Phone Number
Mailing Address
Mailing Address
Country
Street
City
Region
Postal Code
School Name:
*** Hidden*** School Code
Student GPA (C
umulative)
***Hidden*** Set Special Recognition Interest Type
Academic
Arts
Athletic
Club
Communications
Government
Military
Music
Politics
Recreational
Service
Special Recognition
Work
***Hidden*** Set Special Recognition Interest Name
4H
Academic Award
Academic Games
Activity or Interest Not Listed
Amateur Athletic Union (AAU sports)
Archery
Art/Painting/Photography Club
Badminton
Bagpipes
Band
Band Instrument
Baseball
Basketball (boys)
Basketball (girls)
Bicycling,Biking
Bocce
Bowling
Carillon
Cheerleading
Chess Club
Choir
Church Work/Youth Group/Mission Trip
Class Officer
Club Team or Other Sport
Computer Club
Crew
Cross Country (boys)
Cross Country (girls)
Cultural Club
Dance
Debate or Forensics
Diving
Drill Team/Dance Line/Majorette
Eagle Scout
Early College
Education/CommunityCollege/Night School
English Club
Equestrian
ESports
Family and Community Leadership
Fellowship of Christian Athletes
Fitness/Aerobics/Running/Weights
Flag/Color Guard
Football
Foreign Exchange Program
Foreign Lang/Activity Club
Future Business Leaders of America (FBLA)
Future Farmers of America (FFA)
Future Teachers of America
Girl Scout Gold Award
Golf (boys)
Golf (girls)
Gymnastics
Habitat for Humanity
Handbell Choir
History/Law
Ice Hockey
Interact Club
Internet/WebPage/Site Design
Jerb Miller Scholarship Nominee
Journalism/Newspaper
Junior Achievement (JA)
Junior ROTC
Key Club
Lacrosse (boys)
Lacrosse (girls)
Martial Arts
Math/Science Club
Model UN/Congress/Senate
National Honor Society
National Merit Scholar
Orchestra
Orchestral Instrument
Organist
Other Club
Outdoor Activities Hunt/Fish/Rock Climb/Other
Part-time Work
Political or Social Action/Justice Involvement
Private Music Instruction
Racquetball
Relay for Life
Rifle
Robotics
Rotary Youth Leader
Rowing
Sailing/Water Skiing
Salutatorian
School Spirit/Pep Club/Mascot
Science Olympiad
Scorekeeper/Statistician
Scouting (BSA/GSA)
Skiing/Ski Club
Soccer (boys)
Soccer (girls)
Social Media for High School
Softball
Student Council/Govt/Leadership
Students Against Destructive Decisions (SADD)
Swimming (boys)
Swimming (girls)
Synchronized Swimming
Team Handball
Tennis (boys)
Tennis (girls)
Theatre/Drama
Track & Field (boys)
Track & Field (girls)
Tutoring
TV/Broadcasting/Radio
US Achievement Academy
Valedictorian
Videography
Volleyball (boys)
Volleyball (girls)
Volunteer Work
Water Polo
Who's Who
Wrestling
Yearbook
You Tube
Young Presbyterian Scholarship Nominee
Church Information
Church
Email
Phone
Address
Address
Country
Street
City
Region
Postal Code
Pastor 1
Title
Dr.
Mr.
Mrs.
Ms.
Rev.
Rev. Dr.
Pastor 1
First Name
Pastor 1
Middle Initial
Pastor 1
Last Name
Pastor 1
Suffix
Jr.
Sr.
I
II
III
IV
V
VI
VII
VIII
IX
X
IXIX
XX
Pastor 2 Name
Youth / CE
Nominator Information
*** Hidden *** Relationship:
Nominator-Young Presbyterian Scholarship
Title
Dr.
Mr.
Mrs.
Ms.
Prof.
Rev.
First Name
Middle Initial
Last Name
Suffix:
Jr.
Sr.
I
II
III
IV
V
VI
VII
VIII
IX
X
Denomination (select one)
PC (USA)
CPC
ECO
EPC
OPC
Please Select:
Please Select:
Pastor
Youth/CE
Church Member
Certified Lay Pastor (CLP)
Email
Phone
Home Address:
Home Address:
Country
Street
City
Region
Postal Code
Westminster College Alumni?
Westminster College Alumni?
Yes
Class year
*** Hidden*** Relationship Marked as Alumni
Yes
No
NOMINATION
Please tell us more about how the student you are nominating has been involved in your congregation, community and school.
(The nomination box below is not limited. It will expand to fit the text entered.)
*** Hidden*** Interaction Code:
..Student Engagement
..Student Engagement - College Fair
..Student Engagement - Email Received from Parent
..Student Engagement - Email Received from Student
..Student Engagement - ISIR Received Only
..Student Engagement - Letter or Postcard Received from Parent
..Student Engagement - Letter or Postcard Received from Student
..Student Engagement - Outbound Mailer
..Student Engagement - Phone Call - Incoming - Parent
..Student Engagement - Phone Call - Incoming - Student
..Student Engagement - Phone Call - Outgoing - Parent
..Student Engagement - Phone Call - Outgoing - Student
..Student Engagement - Walk In
.Athletic Leads
.Athletic Leads - Baseball
.Athletic Leads - Basketball
.Athletic Leads - Cross Country
.Athletic Leads - Football
.Athletic Leads - Golf
.Athletic Leads - Lacrosse
.Athletic Leads - Soccer
.Athletic Leads - Softball
.Athletic Leads - Swimming
.Athletic Leads - Tennis
.Athletic Leads - Track
.Athletic Leads - Volleyball
ACT Scores
ACT Search
ACT Search - ACT SEARCH EXPANDED NON ATHLETE
ACT Search - ACT SEARCH Expanded VA & WV
ACT Search - ACT SEARCH MUSIC
ACT Search - ACT SEARCH OH 0_2
ACT Search - ACT SEARCH OH 2_4
ACT Search - ACT SEARCH PA 0_2
ACT Search - ACT SEARCH PA 2_4
ACT Search - ACT SEARCH PA 4_6
ACT Search - ACT SEARCH WV Select
Decisions
Decisions - UG Accept Letter Released
Decisions - UG Deny Letter Released
Decisions - UG Hold Notification Released
Early College
ENCOURA Search
ENCOURA Search - ENCOURA Search - 100MR/Majors/.90+/EM
ENCOURA Search - ENCOURA Search - 150MR/Majors/.90+/EM
ENCOURA Search - ENCOURA Search - 50MR/Majors/.90+/EM
ENCOURA Search - ENCOURA Search - NYGeo/.80+/EM
ENCOURA Search - ENCOURA Search OH_0_2
ENCOURA Search - ENCOURA Search OH_2_4
ENCOURA Search - ENCOURA Search PA 0_2
ENCOURA Search - ENCOURA Search PA 2_4
ENCOURA Search - ENCOURA Search PA 4_6
Fellows Civic Accept
Fellows Global Accept
Fellows Leadership Accept
Health Forms Mailed
Lead Source Imports
Lead Source Imports - Alumni Recommendation Form
Lead Source Imports - Alumni Recruiting
Lead Source Imports - CAPPEX
Lead Source Imports - CBSS
Lead Source Imports - Common App Prospect
Lead Source Imports - Common App Suspect
Lead Source Imports - Common Application
Lead Source Imports - Hobsons
Lead Source Imports - ISIR
Lead Source Imports - Jerb Miller Nomination
Lead Source Imports - Niche
Lead Source Imports - NRCCUA AOS
Lead Source Imports - NRCCUA Legacy
Lead Source Imports - NRCCUA Search
Lead Source Imports - NRCCUA WC Declared
Lead Source Imports - Parish Lead
Lead Source Imports - PC & U
Lead Source Imports - Pittsburgh National Fair
Lead Source Imports - Presbyterian USA Conference
Lead Source Imports - RYLA
Lead Source Imports - SAGE
Lead Source Imports - Self-Initiated Account Creation
Lead Source Imports - Web
Lead Source Imports - Young Presbyterian Scholarship Nomination
Payment
PowerFaids
PowerFaids - PowerFaids-ISIR data
Referral
Referral - Referral - Alumni
Referral - Referral - Coach
Referral - Referral - Counselor
Referral - Referral - YPS
SAGE Tuition Rewards
SAT Scores
SAT Search
SAT Search - SAT SEARCH MD
SAT Search - SAT SEARCH MUSIC
SAT Search - SAT SEARCH NY
SAT Search - SAT SEARCH OH 0_2
SAT Search - SAT SEARCH OH 2_4
SAT Search - SAT SEARCH PA 0_2
SAT Search - SAT SEARCH PA 2_4
SAT Search - SAT SEARCH PA 4_6
SAT Search - SAT SEARCH VA Select
SAT Search - SAT SEARCH WV Select
SAT Search - SAT Senior Search
Source
TOEFL Scores
ZHistorical Events
ZHistorical Events - Campus Event
ZHistorical Events - Campus Interview
ZHistorical Events - Campus Interview & Visit
ZHistorical Events - College Day
ZHistorical Events - College Fair
ZHistorical Events - College Night
ZHistorical Events - High School Visit
ZHistorical Events - Sport Camp
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