Teacher Reference Form

Teacher Reference Form

(CONFIDENTIAL INFORMATION REGARDING A SCHOLARSHIP APPLICATION)
Name of Applicant*
Applicant's email*
example@example.com
To the Applicant:

Please give this form to a teacher who knows you well and who has taught you in one of the following areas in the last two years: English, Math, Science, Foreign Language, History/Social Studies. Teachers have many such forms to complete and will appreciate receiving this form from you as soon as possible.

To the Teacher:

This form is a confidential report written on behalf of the scholarship applicant named above. This scholarship is awarded to students who demonstrate unusual academic promise and leadership ability. We think that this form helps to capture this information. If, however, you find this form inadequate and/or restrictive and would rather write a letter, please feel free to do so.

Thank you for your time and efforts.

Scott M. Gibson

Chief Executive Officer

How long have you known the applicant? *
In what subjects have you taught the applicant?*
Will the applicant see a copy of your remarks?*

YesNo
Overall description of candidate*
Please describe the candidate in terms of his/her distinguishing or unusual intellectual traits (positive and/or negative). *
Please describe the candidate in terms of his/her distinguishing or unusual personal traits other than intellectual ones (positive and/or negative). How do you think this student will contribute to the quality of life in his/her community(college and beyond)?*
If you would like to call our attention to any outstanding accomplishments, unusual circumstances, background data, or other information regarding this candidate and his/her application, please do so below.*
Overall estimation of this student’s academic and personal promise:*
Signature
Teacher's Name:*
Teacher's email*
example@example.com
School:*
Date*

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