Inspire Student Nomination Form
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School Name *
School Phone Number *
Principal Name *
Principal Email *
Student First Name *
Student Last Name *
Student's Grade *
Student T-shirt Size (needed to ensure student receives a t-shirt) *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Optional: Parent/Guardian #2 First Name
Optional: Parent/Guardian #2 Last Name
Has the Parent/Guardian signed a photo/video release with LPS?
Clear selection
How does this student act as a leader, inspire other students, is active in their school community, or takes what they learn and applies it to their lives? *
Your Name (if different than the Principal)
Your Email (if different than the Principal)
Submit
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