Nominate a Potential Student

As many as 20% of students accepted to ALA are brought to our attention by community members nominating them directly to us. You may know s young leader, a special young woman or man between 16-19 who has shown leadership potential in your community. In that case, please fill in as many of the details below as you can, and we will contact that young leader directly.

Student's details

First Name:

Last Name:

Gender:

Age:

Citizenship:

Country of residence:

Name of current school:

Location of current school (City):

Location of current school (Country):

Academic record:

Extracurricular Activities:

Preferred Language:

Email:

Phone number #1:

Phone number #2:

Fax number:

Your details

First Name: *

Last Name: *

Organization:

Position held:

Relationship to student: *

Email: *

Phone Number:

Fax Number:

What code is in the image?: *

Enter the characters shown in the image.