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Scholarship - Confidential Form #3
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(Recent Employer, or Acquaintance)
MUST be submitted no later than midnight, May 31, 2025.
Name of Scholarship Applicant (must match their application)
*
First
Last
To be completed by someone who will recommend applicant for scholarship.
*
Recent Employer
Acquaintance
Concerning the above named applicant.
Please furnish whatever information you have which might be useful to the Scholarship Committee.
The Committee would appreciate brief, specific comments on such matters as the following:
1.
The nature and extent of your acquaintance with the applicant;
2.
Your impression of his or her character and personality;
3.
Any knowledge you may have of his or her family’s financial circumstances;
4.
And your estimate of his or her attainments and promise as a student.
Financial Comments
*
Employer's Information
*
First
Last
Employer's Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Employer's Contact Phone #
*
Acquaintance's Information
*
First
Last
Acquaintance's Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Acquaintance's Contact Phone #
*
*** J100 Notes (to be completed by J100 scholarship committee) ***
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