Varsity Club

Your Name

First Name

Last Name

Nominee's Name*

First Name

Last Name

Nominee's School (Include City or town)

Sports you/they currently play

Nominee's Phone

Why do you feel you or the person you are nominating deserves this award?*

List the community service work you have done*

Share why giving back to your community is so important to you*

What type of cause would you choose to donate to*

Food insecurity Medical research Services that support children Homelessness Elderly services and programs Animal shelters

Second type of cause you'd like to donate to*

Food insecurity Medical research Services that support children Homelessness Elderly services and programs Animal shelters

What are your plans for after high school?*

Who is your favorite athlete?*

What is your career goal?*

Who can we contact for a reference? *

Please provide name, title and number

Address

Address Line 1

Address Line 2

City

State

ZIP Code