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NBMBAA Charlotte Chapter Leaders of Tomorrow (LOT) High School Mentoring Program High School Counselor Form

This form should be completed by the applicant’s counselor, advisor, or school Principal. Please provide the information being requested below. This form should be submitted along with a copy of the student’s official school transcript. The requested documents are required to consider program admission of the student applying to the NBMBAA Charlotte LOT Program and should be submitted in its entirety.

Applicant's Mailing Address

Applicant's School Information

Applicant's Evaluation

*Rank in the class is helpful to us. If class rank cannot be cited, please estimate or give some other indication of how the applicant has performed relative to classmates.

3. Are there any special circumstance in the student’s background or home life that would help us better evaluate the applicant?
4. Has this student incurred serious or repeated disciplinary action, been suspended, or left voluntarily for an extended period of time?

7. Please select the following to compare the student with other students in his/her/their class:

Academic Success:
Academic Motivation:
Intellectual Level:
Respect/Concern for Others:
Character and Integrity:
Public Speaking:

Counselor Information

Professional Title:
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