2021 SEAC Scholarship Reference Form

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* 1. Candidate Name

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* 2. Referencer Name

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* 3. Referencer email

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* 4. How do you know the candidate?

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* 5. Please rank the candidate on the following attributes on a scale from 1-5. (1=Poor, 2=Fair, 3=Good, 4=Very Good, 5=Excellent/Outstanding)

	1-Poor	2-Fair	3-Good	4-Very Good	5-Excellent/Outstanding	Unknown
Academic Ability	Academic Ability 1-Poor	Academic Ability 2-Fair	Academic Ability 3-Good	Academic Ability 4-Very Good	Academic Ability 5-Excellent/Outstanding	Academic Ability Unknown
Commitment to Career	Commitment to Career 1-Poor	Commitment to Career 2-Fair	Commitment to Career 3-Good	Commitment to Career 4-Very Good	Commitment to Career 5-Excellent/Outstanding	Commitment to Career Unknown
Leadership/Service/Community Involvement	Leadership/Service/Community Involvement 1-Poor	Leadership/Service/Community Involvement 2-Fair	Leadership/Service/Community Involvement 3-Good	Leadership/Service/Community Involvement 4-Very Good	Leadership/Service/Community Involvement 5-Excellent/Outstanding	Leadership/Service/Community Involvement Unknown
Work Ethic	Work Ethic 1-Poor	Work Ethic 2-Fair	Work Ethic 3-Good	Work Ethic 4-Very Good	Work Ethic 5-Excellent/Outstanding	Work Ethic Unknown

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* 6. Do you recommend this candidate to receive the SEAC Scholarship?

Yes

No

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* 7. Is there anything else you would like to share about the candidate?