Ernest Hollings and EPP scholarship application referenc

OMB# 06480568, expires Dec 31, 2013

Undergraduate Scholarship Programs Application - Reference Form
Reference for:

First Name: …………………

Middle Initial: …

Last Name: …………………

How long and in what association have you known the applicant? (Maximum 8000 characters) *

…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
Compared to other students of comparable age and experience you have known in the last five years, how would you rate the
applicant with respect to the applicant with respect to the following characteristics? *

Below
Average

Average

Good

No Basis for
Very Good Exceptional Judgement

Motivation and persistence toward a productive
career
Imagination and originality of thought
Ability to work with others
Independence and self-reliance
Page 1 of 2

Leadership potential
Mastery of fundamental knowledge in field
Ability to communicate (written/oral)

Add any descriptive comments that will assist in providing a complete picture of the applicant's abilities. (Maximum 8000 characters)

…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
Your Contact information:

Name: ………………… *
Title: …………………*
Department: ………………… *
Institution/Organization: …………………*
Telephone Number: …………………*
E-mail: …………………. *

* Required Information
Revised July 13, 2012 | Questions, Comments? Contact Us | Privacy Policy | NOAA Disclaimer
Publication of the NOAA Office of Education | National Oceanic and Atmospheric Administration | U.S. Department of Commerce
Best viewed in Internet Explorer 5+, Mozilla Firefox 2+, or Safari 3+ | Contact Webmaster

Page 2 of 2