Reference Form for Children of PENC Members Scholarship

Reference Form for Children of PENC Members Scholarship

Thank you for taking the time to submit a reference for the applying student.
Applicant's Name:*

First NameLast Name
Relationship to the Applicant:*
How long you have know the applicant:*
Reference's Name*

First NameLast Name
Your Position/Title:*
Your Contact Phone Number:*
Please enter a valid phone number.
Your Email:*
example@example.com
Please rate the applicant based on the following traits.
Demonstrates leadership qualities.*

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1 is Worst, 5 is Best
Has High expectations for self.*

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1 is Worst, 5 is Best
Commitment to his/her/their education.*

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1 is Worst, 5 is Best
Exhibits classroom initiative.*

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1 is Worst, 5 is Best
Respect among peers.*

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1 is Worst, 5 is Best
Oral and written communication skills.*

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Potential for success.*

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1 is Worst, 5 is Best
Briefly explain why you think this applicant is deserving of such an award.*
Share an example of how the applicant has illustrated a commitment to continuing his/her/their education in a situation where you have had the opportunity to observe.*
Signature*

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Please rate the applicant based on the following traits.