Admission Nomination Form

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All students who are in Grade 4 or 5 during the 2023-2024 school year, are residents of Boston, and attend an eligible school* are able to apply for the Steppingstone Scholars Program.

Please review our Teacher Nomination Guide for a detailed overview of the Steppingstone Scholar profile and Admission criteria, which can help inform your nominations.

*Eligible schools include public and select charter and parochial schools. Students currently attending one of Steppingstone’s placement schools or a school accredited by the Association of Independent Schools In New England (AISNE) are not eligible to apply. If you have questions about whether your student’s school is eligible, please contact Steppingstone at ‪(617) 862-2217‬.

Nominator Information

Nominator Prefix

Nominator Name

I am a...

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Phone

School/Organization Affiliation

Please enter School/Organization Affiliation

Student Information

Student First Name

Student Last Name

Student Gender

Student Birthdate

Current Grade

Current School

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Parent/Guardian Prefix

Parent/Guardian First Name

Parent/Guardian Last Name

Address Line 1

Address Line 2

City

State

Postal Code

Parent/Guardian Email

Parent/Guardian Phone Number

Parent/Guardian Preferred Language

Please note your relation to the student or any additional comments

If you would like to nominate more than one student, please click "Add another response" at the bottom right hand corner of the form!

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