Go For Launch Nomination Fall Intersession 2021
Please complete the following information.
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Email *
Student Details
Please complete the following information about the student you are nominating.
Student's First Name *
Student's Last Name *
Student's School *
Current Grade Level *
Student ID (if you know it)
How did you learn about the program? *
Share why you are nominating this student for the Go For Launch program. *
Electronic Signature
By entering your names and submitting this application, you agree to the terms below.
Agreement Information
I hereby agree that all information on this form and attached forms is true and correct to the best of my knowledge and have made this student aware of this nomination to attend the Midland Go for Launch Enrichment Program on October 18th and 19th, 2021.  
Student's Full Name *
Name of Person making Nomination *
Contact Info for Person making Nomination (used only if needed for follow up) *
If the student is selected to participate in the Midland Go for Launch program they will be notified by October 8th, 2021.
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