Project InSight Fellows Nomination Form

Nominee Information

Please provide the following contact information for the person you would like to nominate:

First Name

Last Name

Email Address

Cell Phone Number

School Name

School Street Address

School City

State

Zipcode

Criteria For Nomination

This fellowship is designed to support youth with a deep interest in pursuing post-secondary work or education in fields related to eye health, vision care, or working with visually impaired populations.
The strongest candidates will have both a deep interest in these fields and experience as evidence of that commitment. For example, a strong candidate may have taken related coursework, obtained a related certification, or held a part-time job or internship in a professional setting providing vision related services.
The Fellowship acts as a bridge into the professional community, and thus is best suited to seniors (12th grade) as they prepare to enter the post-secondary world of work and career building.
However, especially well qualified juniors (11th grade) may also be considered.

Why do you think your nominee would be a good fit for this program?

500 character limit

Nominator Information

Please provide your contact information:

First Name

Last Name

Office Phone Number

Cell Phone Number

Email Address

Please describe your role in the nominee's pursuit of a career in a field related to eye health, vision care, or working with visually impaired populations.

1000 character limit

I am from a different school or organization than my nominee

School or Organization

Address

City

State

Zipcode

Photo/Video Release

By checking this box I confirm that I have on file through my school or program a photo/video release. During the application process we will be conducting an online interview which we would like to record.

By clicking submit below, you acknowledge and give permission for Big Picture Learning to contact you AND THE NOMINEE. Be sure that this is in accordance with your school/district data privacy rules.

Project InSight does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring and firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, clients, volunteers, subcontractors, vendors, and clients.

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