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5th – 6th Grade SLD Nomination Form

EDU – Student Leadership Day (5-6)

Faculty Name(Required)

First Last

Faculty Email Address(Required)

School Name(Required)

School Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Is your school in one of the below networks?(Required)

Chicago Public Schools

Archdiocese of Chicago

None of the Above

Other

Please write in:(Required)

Program Date?(Required)

Tuesday, March 11 (in-person at Illinois Holocaust Museum)

Wednesday, March 12 (in-person at Illinois Holocaust Museum)

My school can come on either date. (Indicate preference below)

Preferred Program Date?(Required)

Tuesday, March 11

Wednesday, March 12

Number of Nominated Students(Required)

Please enter a number from 1 to 10.

Name(s) of Nominated Students(Required)

Please describe why you are nominating the above students.(Required)

Has your school participated in Student Leadership Day before?(Required)

Yes

No

Does your school commit to participating in the full program until 2:30 pm?(Required)

Yes

No

Other

If "other," please elaborate.(Required)

Δ

Photo credits: Danyel Duncan

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