Recommendation Form- Illinois 4-H Scholarship 2025

Illinois 4-H Scholarship Recommendation Form
Recommendations

Thank you for taking the time to fill out a recommendation form for the Illinois 4-H Scholarship. Please fill out the following survey about the 4-H member who contacted you as a reference. If you have any questions or need assistance please contact the Illinois 4-H Club System & Awards Associate, Melissa Irwin at mmirwin@illinois.edu.
Name of Applicant*

First NameLast Name
Name of Evaluator*

First NameLast Name
Title*
Organization*
Relationship with Applicant*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Evaluator, please rate the applicant on the following, by placing checking the appropriate box. (unknown and 1-poor to 5- excellent)

Please note: The applicant will not see this recommendation form. Family members should NOT be asked to complete Reference Evaluations. Written recommendation letters may not be used in lieu of this form.

Leadership

	Unknown	Poor	Below Average	Average	Above Average	Excellent
Ability to work with different & diverse audience
Does fair share of work on joint projects; is an effective team member
Communicates ideas effectively
Ability to get others to work together; compromise
Manages group and individual resources carefully (time, funds, etc.)
Is respected by peers
Works effectively in youth/adult partnerships

Community Service

	Unknown	Poor	Below Average	Average	Above Average	Excellent
Involvement in community service activities
Willingness to work with others, irrespective of diversity within a group
Participates in community service projects of local importance
Volunteers to assist; carries through with responsibilities
Ability to work with authority figures to plan community service activities

Mentoring

	Unknown	Poor	Below Average	Average	Above Average	Excellent
Listens and guides mentees effectively (is not "bossy")
Serves as an appropriate role model
Accepts guidance from others
Exhibits enthusiasm in teaching specific subject matter
Exhibits appropriate behavior in public venues

Illinois 4-H Scholarship Recommendation Form