CLUB COMMITMENT

EACH CLUB LISTED MUST HAVE PRESIDENT ELECT LISTED IN THIS COMPLETED COMMITMENT FORM BEFORE THE SELECTION WILL BE CONSIDERED. Pledges for your GRSP current student must be satisfied as well. Please list below your choices for a student, the school, and the pledge amount as shown on the Statistical Table. *Please note, this application CANNOT be saved. We suggest you print out a PDF and gather the information you need before you start the online form below. Once form is complete and submitted, you will receive a copy to send to club president(s) via email for confirmation.

PLEASE Complete this form by and have the email confirmation copy approved by club president(s) on or before January 6, 2023. Trustees will participate in Student Selection Process on Saturday, January 28, 2023.

Trustee Information

DISTRICT

6900

6910

6920

Trustee

First Last

Trustee Email

Club(s) Information

Total Club(s) PLEDGE AMOUNT for Student:

This total does NOT include the GRSP Foundation contribution.

Lead Club

Lead Club Sponsorship Amount $

Lead Club President Elect's Name

First Last

Lead Club President Elect's Email

Lead Club President Elect's Phone

Additional Clubs

Club 2 Name

Club 2 Sponsorship Amount $

Club 2 President Elect's Name

First Last

Club 2 President Elect's Email

Club 2 President Elect's Phone

Club 3 Name

Club 3 Sponsorship Amount $

Club 3 President Elect's Name

First Last

Club 3 President Elect's Email

Club 3 President Elect's Phone

Club 4 Name

Club 4 Sponsorship Amount

Club 4 President Elect's Name

First Last

Club 4 President Elect's Email

Club 4 President Elect's Phone

Club 5 Name

Club 5 Sponsorship Amount

Club 5 President Elect's Name

First Last

Club 5 President Elect's Email

Club 5 President Elect's Phone

Student Selection

If working with the GRSP Office and contact at preferred college or university for the Direct College Program, do not complete the student name selection as that is for Standard Selection club participants only.

Participating in the Following Program:

Standard Selection (Traditional)

Direct College Selection (Formerly Pilot)

Name of College/University(Required)

If Other, List College/University Student Will Attend:

College or University

If Standard Selection Student, List Statistical Table Total

Please do not factor in the GRSP contribution. (This number should match the total club's pledge amount at top of commitment form under Club's Information)

Standard Selection Student Name

#1 Selection on First Line, Add Alternate Selections with + line as needed with second choice on second line, etc... up to six lines total.

Student ID #

From Selection E-Book (add ID# line for each prospect)

Host Family (Lead) Information

If additional host families will assist with the student, please inform GRSP office with an email. If the host family is not known, leave fields blank and follow up correspondence will be made.

Host Family Name

First Last

Host Family Email

Host Family Contact Phone

Host Family Spouse Name

First Last

Host Family Spouse Email

Host Family Spouse Phone

Additional Host Families

Host Family 2 Name

First Last

Host Family 2 Email

Host Family 2 Contact Phone

Host Family 2 Spouse Name

First Last

Host Family 2 Spouse Email

Host Family 2 Spouse Phone

Host Family 3 Name

First Last

Host Family 3 Email

Host Family 3 Contact Phone

Host Family 3 Spouse Name

First Last

Host Family 3 Spouse Email

Host Family 3 Spouse Phone

Host Family 4 Name

First Last

Host Family 4 Email

Host Family 4 Contact Phone

Host Family 4 Spouse Name

First Last

Host Family 4 Spouse Email

Host Family 4 Spouse Phone

Host Family 5 Name

First Last

Host Family 5 Email

Host Family 5 Phone

Host Family 5 Spouse Name

First Last

Host Family 5 Spouse Email

Host Family 5 Spouse Phone

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Club Commitment

CLUB COMMITMENT

Trustee Information

Club(s) Information

Student Selection

Host Family (Lead) Information

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