BLOOM COLLEGE SCHOLARSHIP APPLICATION

PERSONAL REFERENCE

Name of Applicant *
Name of Applicant
Recommender Details
Your Name *
Your Name
Phone *
Phone
Please rate the applicant on the following. Check one box for each trait.
RESPONSIBILITY *
MATURITY *
SELF-MOTIVATION *
CAN MOTIVATE OTHERS *
TRUSTWORTHINESS *
RELIABILITY *
GOAL DRIVEN *
In summary, please indicate your recommendation *
Electronic Signature *
Electronic Signature
Date *
Date