Nominate a Student

Governor’s School for the Sciences & Engineering at the University of Tennessee, Knoxville

This form should be completed only by the nominator. Nominations for the Tennessee Governor’s Schools must be made by high school educators who can speak to the student’s potential for success in the program.

INSTRUCTIONS: Enter the student’s name and email address and their parent/guardian’s name and email address below. The student and their parent/guardian will each receive an email with information on how to complete and submit their portion of the application.

**To ensure delivery of the student form, please do not use the student’s school assigned email address. The student will also need to use this email address when applying.

Student Information

Student First Name*

Student Middle Name

Student Last Name*

Student Email Address*

Student Date of Birth*

Grade*

11th

10th

Cumulative GPA*

Class Size*

Class Rank*

Parent/Guardian Information

Parent First Name*

Parent Last Name*

Parent Email Address*

School Information

School Name*

School District Name*

School Type*

School Street Address*

School City*

School ZIP Code*

Nominator Information

Nominator First Name*

Nominator Last Name*

Nominator Email Address*
Use your institutional email address. Submissions from anonymous email addresses (Gmail, Hotmail, Yahoo) may be subject to additional review.

Nominator Phone Number*

Elective Focus

CTE*

Yes

No

Please specify career cluster.

Please specify

Relevant Test Scores

Please include all available information. Use the latest scores available.

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Add another score

Yes

Test Name

Please specify test

Grade Administered

Score

Percentile Ranking

Attendance and Discipline

Number of days absent prior academic year*

Number of days absent current academic year (to date)*

Number of disciplinary referrals prior academic year*

Number of disciplinary referrals current academic year (to date)*

Please explain the disciplinary referrals*

Counselor/Administrator Verification

Please provide narrative comments about this to help with our evaluation. Narrative comments are extremely helpful to the selection committee during the evaluation process.*

Have you reviewed the student's academic record?*

Yes

No

Does the student meet the prerequisites of the Governor's School for Science and Engineering?*

Yes

No

In your opinion, how academically qualified is the student for the Governor's School experience?*

Highly Qualified

Qualified

Marginally Qualified

Not Qualified

Supporting Documentation*

Upload a copy of the student's transcript and any other documentation (e.g. test scores).

The University of Tennessee, Knoxville

Undergraduate Admissions

GSSE Nomination Form

Nominate a Student

Student Information

Parent/Guardian Information

School Information

Nominator Information

Elective Focus

Relevant Test Scores

Attendance and Discipline

Counselor/Administrator Verification

Supporting Documentation*