USC Upstate Junior Scholars Nomination Form

*** To be completed by high school guidance counselors only ***

Please fill out the form completely for each nominee. Up to five students may be nominated per high school. All forms must be submitted by March 1, 2013. Contact Donette Stewart, Associate Vice Chancellor Enrollment Services, with questions.

High School: 

CEEB Code: 

Counselor's Name: 

Counselor's Phone Number: 

Counselor's E-mail: 

Minimum Requirements:

  • 100 PSAT
  • 1100 SAT (Reading/Math)
  • 3.25 GPA

Nomination #1

Name: 

Address: 

City:   State:   Zip: 

Phone Number: 

PSAT/SAT Score: V   M    

ACT Composite Score:   

SC Uniform High School GPA: 

Nomination #2

Name:

Address:

City:   State:   Zip: 

Phone Number:

PSAT/SAT Score: V   M   

ACT Composite Score:   

SC Uniform High School GPA:

Nomination #3

Name:

Address:

City:   State:   Zip: 

Phone Number:

PSAT/SAT Score: V   M   

ACT Composite Score:   

SC Uniform High School GPA:

Nomination #4

Name:

Address:

City:   State:   Zip: 

Phone Number:

PSAT/SAT Score: V   M    

ACT Composite Score:    

SC Uniform High School GPA:

Nomination #5

Name:

Address:

City:   State:   Zip: 

Phone Number:

PSAT/SAT Score: V   M    

ACT Composite Score:    

SC Uniform High School GPA: