Educational Scholarship Reference Form

A student applying for our Educational Scholarship has requested that you fill out a reference form on their behalf to support their scholarship application. Based on your experience(s) with the applicant, we would appreciate any insight you may be able to provide. Please be as specific as possible. You don’t need to list the applicant’s activities, grades, or future plans; those are reported in the application form that the student completes. All information will be held in the strictest confidence. All reference forms must be submitted to the cooperative by Friday, February 24, 2023.

To access a PDF copy of the reference form, click here.

 

Name of Student Applicant(Required)
Scholastic(Required)
Leadership(Required)
Adaptability(Required)
Initiative(Required)
Reliability(Required)
Integrity(Required)
Self-Discipline(Required)
Attendance(Required)
If you were a teacher or coach, list the subject. If employer, list the company. Please include length of time you have known the applicant and any additional comments
Name(Required)