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1.Student's Information
Student's Name
Student's Phone Number/Email
Student's Mailing Address
City
Zip
Student's Grade
School
School Phone Number(s)
School Principal
Principal Email
School Counselor
Counselor Email
2.Your Information
Your Name
Relationship to Student
Your Address
Your Phone Number (Day)
Your Phone Number (Evening)
3.The purpose of having Classroom Champions is to recognize high school seniors who not only do well on the field or court, but also do well in the classroom. Please tell us why this student should be recognized as a Classroom Champion. The following information is required in your nomination:
Class Rank and GPA
College planning on attending & major (if applicable)
4.Sports they are involved with
5.Awards Received
6.Extracurricular Activities Including Community Activities
7.Academic Achievements Including Scholarships
8.Please enter your date of birth.
Month* Day* Year*

9.Terms and Conditions
I have read, understand, and agree to the Website usage agreement and privacy policy.
* represents required fields

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