Salkehatchie Scholars Recommendation
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Student Reference
Name of Student
First Name
Last Name
How do you know the student?
Rank the student's potential:
Rows
Excellent
Above Average
Average
Fair
Poor
NA
Unknown
Academic Potential
Academic Motivation
Academic Self-Efficacy
Leadership Qualities
Courteous/Positive Behavior
Time Mangement Skills
Analytical Thinking Skills
Organization Skills
Interpersonal Skills
Relationship with Peers
Maturity
Ability to Work Collaboratively
Overall Assessment of this student for the Salkehatchie Scholars Honors Program:
Please Select
Highly Recommended
Recommended
Recommended with Reservation
Not Recommended
Please provide any additional information that may be helpful with this application.
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: