Oklahoma Leadership Academy

 

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*Denotes a required field

Nominator Information
Salutation (eg: Mr., Ms., Dr., etc.):
*First Name:  
Middle Name:
*Last Name:  
Title:
Name of School:
Mailing Address:
City:
State:
Zip:
*Email Address:  
Phone:
Fax:
 

Nominee Information
*First Name:  
Middle Name:
*Last Name:  
Gender:
Grade in Fall '08:
Mailing Address:
City:
State:
Zip:
*Email Address:  
Phone:
Father's Name:
Father's Contact Number:
Mother's Name:
Mother's Contact Number:
"I prefer that you contact me directly and I will contact the student" (Check box)
 

Nominee Character Reference
Describe the leadership activities you have seen this student participate in:
Why have you nominated this student?
Describe one attribute or characteristic that illustrates this nominee's unique ability:
This student is among the top 5% of young leaders in the state:
This student is considered a leader by his/her peers:
This student is a person of exceptional character:
This student is respectful to colleagues:
This student has significant leadership potential:
This student is an excellent communicator:
This student works well in a team:
This student is dependable:
This student has the capacity to be a future leader in the State of Oklahoma:
This student has a consistently positive attitute: