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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 14, 2022.
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
0
1
2
3
4
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)
Abraham Baldwin Agricultural College (ABAC)
Augusta University
Berry College
Clayton State University
College of Coastal Georgia
Columbus State University
Dalton State College
Georgia Gwinnett College
Georgia Southwestern State University
Georgia State University
Georgia Southern University at Armstrong Campus
Georgia Southern University
Kennesaw State University
University of North Georgia
Oglethorpe University
Piedmont University
Reinhardt University
University of Georgia (UGA)
University of North Georgia (UNG)
University of West Georgia (UWG)
Valdosta State University
Wesleyan College
Young Harris College
Other
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
Add
Remove
#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 #
Add
Remove
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
0
1
2
3
4
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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