Reference form for scholarship applications

Please use your personal knowledge of the applicant to respond to the following: 5=excellent, 4=good, 3=satisfactory, 2=fair, 1=poor, xx=no opinion

good citizenship
independent thinker
perseverance
initiative
work ethic
dependability
character
responsibility
follow-through
maturity
How long have you known the applicant and in what capacity?
In your opinion, what personal strengths will enable the applicant to be successful in her/his college endeavors?
Do you feel this aplicant is a worthy recipient for this scholarship? Please explain.
What else would you like us to know about this applicant?
Name
Date / Time