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Recommendation

Scholarship Recommendation Form

Name of ECC Student Applicant(Required)

First Last

Address of ECC Student Applicant

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student's intended area of study

Writer of the Reference:

How long have you known the ECC student applicant and in what capacity?(Required)

How has the applicant demonstrated leadership in group activities?(Required)

What do you consider the applicant's main strengths?(Required)

Please rate the student on the following characteristics:

Character(Required)

Poor

Fair

Good

Excellent

Motivation(Required)

Poor

Fair

Good

Excellent

Disciplined work habits(Required)

Poor

Fair

Good

Excellent

Dependability(Required)

Poor

Fair

Good

Excellent

What is your opinion of the applicant's lifestyle, values, circle of friends and attitude?(Required)

How does the applicant relate with those outside his or her peer group (younger, older, disadvantaged, those in authority, etc.)?

Do you place full confidence in the applicant's integrity and honesty?(Required)

Overall Recommendation(Required)

Poor

Fair

Good

Excellent

Reference Writer's Name(Required)

First Last

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer(Required)

Position(Required)

Signature(Required)

Name

This field is for validation purposes and should be left unchanged.

It is the policy of the Iowa Valley Community College District not to discriminate in its programs, activities, or employment on the basis of race, color, national origin, sex, disability, age, sexual orientation, gender identity, creed, religion, and actual or potential family, parental or marital status. If you have questions or complaints related to compliance with this policy, please contact the Vice President of Administration, serving as the District Equity Officer, 3702 S. Center Street, Marshalltown, IA 50158, 800-284-4823, Equity@iavalley.edu, or the Director of the Office for Civil Rights U.S. Department of Education, John C. Kluczynski Federal Building, 230 S. Dearborn Street, 37th Floor, Chicago, IL 60604-7204, Telephone: (312) 730-1560 Facsimile: (312) 730-1576, TDD 800-877-8339 Email: OCR.Chicago@ed.gov.

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1100 College Avenue
Iowa Falls, Iowa 50126

CONTACT

641-648-4611

1-800-322-9235

eccinfo@iavalley.edu

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