Lainer Fellows: 2025 Nomination Form

Nominator Information: Please tell us about yourself and your organization.

Nominator's Full Name

Nominator's role and organization:

Nominator's email:

Nominator's phone number:

Nominee Information: Please tell us about the teen you are nominating for the Lainer Fellows program.

Nominee's full name

Nominee's role in the organization:

Nominee's email:

Nominee's phone number:

Please tell us a little bit about the nominee. What makes them stand out as a leader in your organization? How have they contributed as an educator?

What do you hope the nominee gets out of the Lainer fellowship? Are there skills you'd like to see the nominee develop?

Is there anything else we should know about your nominee?