AGS 2019 | Composite Nomination Information Sheet
2019 ARKANSAS GOVERNOR'S SCHOOL
COMPOSITE NOMINATION INFORMATION SHEET
Superintendent or Principal (Indicate position) Please print __________________________Signature __________________
Signing indicates a school official has previewed each student’s audition for clarity and appropriateness of material.
High School Name School District________________________
High School Address __________________________________________ Phone Number _______________________
Contact Person_________________________ E-mail address ______________________ Phone Number ___________
Size of Junior Class________ Demographics of the Junior Class (percent): Asian Black Hispanic
American Indian/Alaska Native Hawaiian/Pacific Islander White Two or More Races
Total Nominations________ Demographics of the nominated group (percent): Asian Black Hispanic
American Indian/Alaska Native Hawaiian/Pacific Islander White Two or More Races
Please list in alphabetical order all students nominated for Arkansas Governor's School. PLEASE DUPLICATE AS NEEDED
Mark with a “1 or “2” to indicate student preference for each Area I in which the student is applying (no more than two)
STUDENT NAME
CS
CM
D
LA
IM
M
NS
SS
VA
EXAMPLE: Adams, John
1
2
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
KEY: CS Cybersecurity Specialty Program CM - Choral Music D Drama LA Language Arts
IM- Instrumental Music M Math NS Natural Science SS Social Science VA Visual Arts