Summer 2026 Scholarship Application: Academic Reference + Recommendation

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Teacher/Principal/Guidance Counselor Name
First Name
Last Name
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Teacher/Principal/Guidance Counselor Email* This field is required.
example@example.com
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Scholarship Applicant Name* This field is required.Please put the name of the camper who is applying for this scholarship.
First Name
Last Name
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Please rank and comment on your agreement with the following statement about the scholarship applicant: "Eager to learn and try new things"* This field is required.The number scale below is 1-5, with one representing "strongly disagree" and five representing "strongly agree." Your comments and descriptions will be greatly appreciated for review and considerations between other applicants.
Please Select
Please Select
1 (Strongly Disagree)
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3
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5 (Strongly Agree)
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Please rank and comment on your agreement with the following statement about the scholarship applicant: "Has a strong interest in science"* This field is required.The number scale below is 1-5, with one representing "strongly disagree" and five representing "strongly agree." Your comments and descriptions will be greatly appreciated for review and considerations between other applicants.
Please Select
Please Select
1 (Strongly Disagree)
2
3
4
5 (Strongly Agree)
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Please rank and comment on your agreement with the following statement about the scholarship applicant: "Follows directions and obeys rules"* This field is required.The number scale below is 1-5, with one representing "strongly disagree" and five representing "strongly agree." Your comments and descriptions will be greatly appreciated for review and considerations between other applicants.
Please Select
Please Select
1 (Strongly Disagree)
2
3
4
5 (Strongly Agree)
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Please rank and comment on your agreement with the following statement about the scholarship applicant: "Works well with other students"* This field is required.The number scale below is 1-5, with one representing "strongly disagree" and five representing "strongly agree." Your comments and descriptions will be greatly appreciated for review and considerations between other applicants.
Please Select
Please Select
1 (Strongly Disagree)
2
3
4
5 (Strongly Agree)
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Please rank and comment on your agreement with the following statement about the scholarship applicant: "Demonstrates respect for peers, adults, and property"* This field is required.The number scale below is 1-5, with one representing "strongly disagree" and five representing "strongly agree." Your comments and descriptions will be greatly appreciated for review and considerations between other applicants.
Please Select
Please Select
1 (Strongly Disagree)
2
3
4
5 (Strongly Agree)
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Please rank and comment on your agreement with the following statement about the scholarship applicant: "Demonstrates respect for peers, adults, and property"* This field is required.The number scale below is 1-5, with one representing "strongly disagree" and five representing "strongly agree." Your comments and descriptions will be greatly appreciated for review and considerations between other applicants.
Please Select
Please Select
1 (Strongly Disagree)
2
3
4
5 (Strongly Agree)
10
Please rank and comment on your agreement with the following statement about the scholarship applicant: "Has a good understanding of science for their grade level"* This field is required.The number scale below is 1-5, with one representing "strongly disagree" and five representing "strongly agree." Your comments and descriptions will be greatly appreciated for review and considerations between other applicants.
Please Select
Please Select
1 (Strongly Disagree)
2
3
4
5 (Strongly Agree)
11
SignatureYour signature here indicates that you have filled out this information with accurate information obtained from observations of this applicant's academic abilities and interest.
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