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ABOUT
GIVE
BLOOM COLLEGE SCHOLARSHIP APPLICATION
PERSONAL REFERENCE
Name of Applicant
*
First Name
Last Name
Recommender Details
Your Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
How long have you known the applicant?
*
In what capacity?
*
Please rate the applicant on the following. Check one box for each trait.
RESPONSIBILITY
*
Poor
Average
Good
Very Good
Excellent
MATURITY
*
Poor
Average
Good
Very Good
Excellent
SELF-MOTIVATION
*
Poor
Average
Good
Very Good
Excellent
CAN MOTIVATE OTHERS
*
Poor
Average
Good
Very Good
Excellent
TRUSTWORTHINESS
*
Poor
Average
Good
Very Good
Excellent
RELIABILITY
*
Poor
Average
Good
Very Good
Excellent
GOAL DRIVEN
*
Poor
Average
Good
Very Good
Excellent
What do you consider the applicant's most outstanding talents or characteristics?
*
What could prove to be a challenge to the applicant in the traditional college setting?
*
Is there anything else you would like to tell us about the applicant?
*
In summary, please indicate your recommendation
*
Recommend strongly
Recommend
Recommend with hesitation
Do not recommend at this time
May we contact you if we have any further questions about the applicant?
*
Yes
No
Electronic Signature
*
First Name
Last Name
Date
*
MM
DD
YYYY
Thank you!
