Student Nomination Form for Teachers
2019 RISE Internship Program for High School Students


Deadline for Nomination: February 8, 2019


This form should be used by teachers and counselors to nominate students for the 2019 RISE Internship Program. We encourage you to nominate one to three students who meet the eligibility criteria (see below) and would most benefit from participating. You will enter information for each student nomination (up to three). Questions or problems? Please contact Maiken Bruhis.

Provide Your Contact Information

Your First Name
Your Last Name
High School/Organization
School Zip Code
Current Title  (e.g., Chemistry Teacher, Math Teacher, Counselor, etc.)
Your School Email Address
Confirm Your School Email Address
Your Contact Phone Number


Understand Eligibility Information

Students must meet ALL of these eligibility criteria (there are no exceptions!) to be considered:
  • Have at least a 3.5 (weighted) GPA
  • Have earned all As and Bs in science and math classes completed in high school
  • Be 16 years old by June 19, 2019
  • Be legally entitled to work in the U.S. (i.e., must have a Social Security Number)
  • Attend high school locally (within about a 25-mile radius of Stanford) and be able to commute to the Stanford campus on a daily basis
  • Be a rising sophomore, junior or senior in summer 2019
  • Have an interest in science, medicine, math, psychology, engineering or computer science
  • Have demonstrated intelligence, maturity and initiative
  • Be from a low income family
  • Will be the first in their families (other than siblings) to go to a 4-year college
I have read and understand the eligibility criteria.


Provide Student Information

We will use this information to share application instructions with this student.
Student's First Name
Student's Last Name
Student's Email Address
Confirm Student's Email Address
Student's Cell Phone Number
 
Nominate another student  
Student's First Name
Student's Last Name
Student's Email Address
Confirm Student's Email Address
Student's Cell Phone Number
 
Nominate another student  
Student's First Name
Student's Last Name
Student's Email Address
ConfirmStudent's Email Address
Student's Cell Phone Number