Nominate a Student | Panther Pathway to Success Program

A four-day summer program designed to help high school students build the knowledge, skills and confidence to succeed in college.

Please note this program is for rising high school seniors. That means this student is currently a junior and will be starting their senior year in the fall.

Relationship to Nominee

Self

High school teacher, counselor, mentor, or coach

About the Nominee

Student’s Name(Required)

First Last

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Student’s Address(Required)

Street Address Address Line 2 City State ZIP Code

Student’s Personal Email

If possible, please provide a student personal email as the school email addresses (such as NYC DOE student accounts) sometimes block the acceptance letters from arriving to the students inbox.

Student’s School Email

Email provided by their high school.

Personal Email(Required)

Please provide your personal email as school email addresses (such as NYC DOE student accounts) sometimes block the acceptance letters from arriving to the students inbox.

School Email

Email provided by your high school.

Phone(Required)

Student’s Phone(Required)

Student’s High School(Required)

High School(Required)

GPA(Required)

High School Graduation Year(Required)

Area of Interest or Anticipated Major

What are you interested in studying in college?

Area of Interest or Anticipated Major

What is this student interested in studying in college?

Parent or Guardian’s Name(Required)

First Last

Parent or Guardian’s Phone(Required)

Your Contact Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Your Connection to the Student(Required)

Provide a short explanation of your role and experience working with the student.

Time Known(Required)

Tell us how long you’ve known the student.

Nomination Statement

Statement(Required)

Please let us know why you would like to join the upcoming Panther Pathway to Student Success college-readiness program at Adelphi University. Be sure to provide as much information necessary to highlight your nomination (including hobbies, skills, career aspirations, etc.).

Statement(Required)

Please let us know why you would like to nominate this student for the upcoming Panther Pathway to Student Success college-readiness program at Adelphi University. Be sure to provide as much information necessary to highlight your nominee (including hobbies, skills, career aspirations, etc.).

Name

This field is for validation purposes and should be left unchanged.

Program Contact

Cathy Harrison
MS

Executive Assistant To the Vice President and Special Projects Coordinator

Division of Student Affairs
Contact

charrison@adelphi.edu

516.877.3146

Nexus Building 305