Scholarship Application

Part II

Applicant's Direct Supervisor's Information
Supervisor First Name*
Supervisor Last Name*
Supervisor Phone*
Supervisor Fax
Supervisor E-Mail*
Applicant Information
Applicant First Name*
Applicant Last Name*
Title*
Applicant Institution*
Department*
Address*
City*
State
ZIP Code*
Applicant email*
Please certify that the applicant is a full-time employee at your institution
How long have you known the applicant and in what capacity
Give a fair and objective description of the applicant. Include information about this employee's character, motivation, special talents, and leadership ability
Please give your endorsement and comments