Chancellor's Associates Scholars Program (CASP) Nomination Form

Nomination Instructions

Complete this form for your school/organization nominee (one student per nomination form)
Completed nomination form must be submitted no later than Friday, January 5, 2024

Nominee Information

Complete this portion for the student you would like to nominate.

First Name*

Middle Name

Last Name*

Email*(as used on the UC Application)

Phone Number

Birthdate*

Applicant Type*

First-Year

Transfer

Entry Term*

Current School*

Class Rank/ Percentile (if applicable)

Eligibility & Student Attributes

All nominees must be California residents for tuition purposes or AB540 (final determination to be made by UC San Diego), apply for admission to UC San Diego and submit the Free Application for Federal Student Aid (FAFSA) OR California Dream Act Application.

Program Name*

2. Name three characteristics that describe the nominee and how they demonstrate these qualities.

(1 of 3)*

(2 of 3)*

(3 of 3)*

3. What makes this student a good candidate for the CASP Scholarship at UC San Diego and why are you nominating them?*(Limit: 500 words)

Nominating Representative Information

Please enter your information.

First Name*

Last Name*

Title*

Email*

Phone Number*

Organization Type*

School

Organization

School*

Organization Name*

City*

State*

School/Organization Endorsement

Please provide the information below to verify that this nominee has been endorsed by your school/organization leadership.

First Name*

Last Name*

Title*

Email*

Phone Number*

Confirmation

By providing my initials here I certify that:*

I am an official representative of the school/organization indicated on this nomination form;
This candidate has been approved by school/organization leadership; and
The information provided in this nomination is accurate.