CHSI Application | Celebrating High School Innovators

2020-21 Application

Team Leader Name *

Team Leader Last Name *

Team Leader Street Address *

Team Leader City *

Team Leader State/Province *

Team Leader ZIP / Postal Code *

Team Leader Email Address *

Team Leader Phone Number *

School Name *

If homeschooled, put homeschool0 / 180

Principal Name *If homeschooled, put homeschool

Team Leader Year in School *

Team Leader Parent/Guardian Name *

0 / 180

Team Leader Parental Email Address *

Team Advisor *

0 / 180

Team Advisor Email *

0 / 180

Influential Person *

What person has made the biggest impact on you?0 / 180

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