2023 Michael K. Falligant Scholarship Recommendation Form Survey

Question Title

* 1. Please provide the following information.

Student

Institution:

Date:

Name of person providing recommendation:

Title:

Email Address:

Phone Number:

Question Title

* 2. Please rate the student on each of the following areas of personal competence.

	No Basis	Below Average	Average	Top 25%	Top 10%	Top 5%
Leadership	Leadership No Basis	Leadership Below Average	Leadership Average	Leadership Top 25%	Leadership Top 10%	Leadership Top 5%
Intellectual Promise	Intellectual Promise No Basis	Intellectual Promise Below Average	Intellectual Promise Average	Intellectual Promise Top 25%	Intellectual Promise Top 10%	Intellectual Promise Top 5%
Creative, Original Thought	Creative, Original Thought No Basis	Creative, Original Thought Below Average	Creative, Original Thought Average	Creative, Original Thought Top 25%	Creative, Original Thought Top 10%	Creative, Original Thought Top 5%
Integrity	Integrity No Basis	Integrity Below Average	Integrity Average	Integrity Top 25%	Integrity Top 10%	Integrity Top 5%
Confidence	Confidence No Basis	Confidence Below Average	Confidence Average	Confidence Top 25%	Confidence Top 10%	Confidence Top 5%
Independence	Independence No Basis	Independence Below Average	Independence Average	Independence Top 25%	Independence Top 10%	Independence Top 5%
Motivation	Motivation No Basis	Motivation Below Average	Motivation Average	Motivation Top 25%	Motivation Top 10%	Motivation Top 5%
Productive Class Discussion	Productive Class Discussion No Basis	Productive Class Discussion Below Average	Productive Class Discussion Average	Productive Class Discussion Top 25%	Productive Class Discussion Top 10%	Productive Class Discussion Top 5%
Maturity	Maturity No Basis	Maturity Below Average	Maturity Average	Maturity Top 25%	Maturity Top 10%	Maturity Top 5%
Reaction to Setbacks	Reaction to Setbacks No Basis	Reaction to Setbacks Below Average	Reaction to Setbacks Average	Reaction to Setbacks Top 25%	Reaction to Setbacks Top 10%	Reaction to Setbacks Top 5%

Question Title

* 3. Please choose one.

Highly recommended

Recommended

Recommended with reservations

Not recommended

Question Title

* 4. Additional comments about this applicant:

Please send any additional letters of recommendation via email to Careers@crisiscenterbham.org, please place Michael K. Falligant Scholarship in the subject line, or by U.S. Mail to the Crisis Center, 3620 8th Ave S, Suite 110, Birmingham, AL 35222.