NOMINATION FORM
2010 Chicago Tribune Illinois High School All-State Academic Team
(This page to be completed by principal or counselor.)
Your School’s Region Number (See enclosed map) _______
Student’s Name ______________________________________ Date of birth _______________
Street Address __________________________________________________________________
City, ZIP code __________________________________________________________________
Phone _____________________________E-mail ______________________________________
First and Last Names of Each Parent _________________________________________________
School Name ___________________________________________________________________
Address, city, ZIP ________________________________________________________________
Telephone _______________________________________ County _______________________
Principal’s Name ________________________________________________________________
Student’s rank in senior class _____Number of students in class ________
Check here _______ if your school doesn’t rank students.
Please apply the formulas below to your nominee’s grade point average and to his/her SAT or ACT
score (either score but not both). These calculations are intended to covert nominees’ grades and test scores to
1,000-point scales in order to facilitate and simplify the work of our judges.
Principal’s signature_______________________________________________________
Line 1 Grade point average
1
Select either ACT or SAT, not both:
Line 2 Composite ACT score
Multiply by 27.78 = 2
OR
OR
Line 3
Total SAT score
(Reading, Math, Writing)
Divide by 2.4 =
3
Line 1 plus either "Line 2" or "Line 3" =
4
Multiply by 250 on a 4.0
scale, or by 200 on a 5.0
scale =
2
(The following to be completed by nominated student.)
Student’s name_______________________________________
Please respond to these questions. You may use additional sheets of paper if desired. Student’s
name should appear on each page.
1) What i