INS Superior Student Nomination Form

Thank you for joining Iowa Network Services (INS) and Learfield Communications in supporting the INS Superior Student of the Month program.

We encourage you to nominate a deserving individual who has distinguished themselves in the categories listed below. For complete program information, please review the
Official Nomination Terms and Conditions.

To begin the nomination process, complete this form, consent to the Terms and Conditions, and submit. You will then receive a confirmation code with instructions to call in a voice message to complete your nomination.

Student Nominee Information

*First Name

*Last Name

*School District

*E-Mail

*Telephone

*Street 1

Street 2

*City

*Zip

*Grade

Your Information

*First Name

*Last Name

*E-Mail

*Daytime Telephone

*Street 1

Street 2

*City

*Zip

Award Categories Please select one or all that apply

Enter a detailed explanation of why you believe this individual deserves to be recognized as an INS Superior Student.

I agree to the Terms and Conditions