Complete the form below to refer a student to the Golden Apple Scholars Program in Illinois. To refer a student in New Mexico, click here.

Students will receive an email with login information and a link to apply online.

Student's Name

First Name

Last Name

Student's Email Address

Student's Mobile Number

Student's Current School

Student's State of Residence

Candidate must be a resident of Illinois to qualify.

Illinois

Your Name

First Name

Last Name

Your Email

Your Relationship to Student

How did you hear about the Scholars program?

Please indicate if you are affiliated with any of the following organizations:

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