UCAC 2022-2023 Cotillion Application

Cotillion Recommendation Form

For Teacher, Principal, or Counselor
This student is seeking to be a participant in the Cotillion sponsored by the Union County Alumnae Chapter of Delta Sigma Theta Sorority, Incorporated (UCAC). Please complete the form in its entirety. You will submit the form directly to UCAC using the submit button at the end of this form.

It is the responsibility of the student/applicant to make sure this form is completed, signed and submitted to UCAC by Monday, September 16, 2024.
Student/Applicant’s Name*
How long have you known the applicant?*
In what capacity have you known the applicant?*

Based on your knowledge of the applicant, please complete the following:

	Outstanding	Good	Fair	Poor	Unknown
Intellectual Ability
Leadership
Creativity and Imagination
Maturity and Judgement
Motivation and Initiative
Personal Integrity
Ability to get along with peers
Poise

Please use the space below to make additional comments regarding the applicant's academic ability, school/community service, personal qualities, potential for success and/or any other information that may be helpful in evaluating the applicant.
Has the student been involved in any disciplinary action within the last 2 years that you are aware of?*

NoYes
If yes, please explain.
Name (type)*
Date*

MonthDayYear
Date
Title*
School*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Signature*

Clear
All materials are to be submitted by the September 16, 2024 due date. Late submissions will not be considered.

You may print a copy using the button below. Once you hit submit, you will not be able to modify your recommendation.
Should be Empty:

Cotillion Recommendation Form