Get Connie Collier 4-H Scholarship Award Reference Form

Connie Collier 4-H Scholarship Award Reference Form Scholarship applicants must provide this form to each of three references. 7. Please use this space to make any additional comments about the applicant. Thank you for taking the time to help us with the selection of the recipient of the Connie Collier 4-H Scholarship Award. Applicants must fill out the top portion of the form* References are requested to complete this form and mail/email it to Celeste Crisman APSC 0306 380 Litton Reaves Virginia Tech Blacksburg VA 24061 ccrisman vt. edu This portion to be completed by applicant Applicant s Name Street Address City/State/Zip Code Daytime Phone Cell Phone Email Name 1. How long have you known the applicant 2. What is your relationship to applicant 3. Please rate the following with 1 Poor 3 Average 5 Outstanding NA not applicable N/A Ability to get along with others Leadership potential Citizenship Community Service Responsibility Trustworthiness Respect for people property and self Fairness Caring Virginia Cooperative Extension programs and employment are open to all regardless of race color national origin sex religion age disability political beliefs sexual orientation or marital or family status. An equal opportunity/affirmative action employer. Issued in furtherance of Cooperative Education work Virginia Polytechnic Institute and State University Virginia State University and the U*S* Department of Agriculture cooperating. Edwin J* Jones Director Virginia Cooperative Extension Virginia Tech Blacksburg Jewel E* Hairston Intern Administrator 1890 Extension Program Virginia State Petersburg. 4. Please describe one of the applicant s strongest character traits. 6. Please share your knowledge of the applicant s experience and dedication to 4-H and horses. Applicants must fill out the top portion of the form* References are requested to complete this form and mail/email it to Celeste Crisman APSC 0306 380 Litton Reaves Virginia Tech Blacksburg VA 24061 ccrisman vt. edu This portion to be completed by applicant Applicant s Name Street Address City/State/Zip Code Daytime Phone Cell Phone Email Name 1. edu This portion to be completed by applicant Applicant s Name Street Address City/State/Zip Code Daytime Phone Cell Phone Email Name 1. How long have you known the applicant 2. What is your relationship to applicant 3. Please rate the following with 1 Poor 3 Average 5 Outstanding NA not applicable N/A Ability to get along with others Leadership potential Citizenship Community Service Responsibility Trustworthiness Respect for people property and self Fairness Caring Virginia Cooperative Extension programs and employment are open to all regardless of race color national origin sex religion age disability political beliefs sexual orientation or marital or family status. How long have you known the applicant 2. What is your relationship to applicant 3. Please rate the following with 1 Poor 3 Average 5 Outstanding NA not applicable N/A Ability to get along with others Leadership potential Citizenship Community Service Responsibility Trustworthiness Respect for people property and self Fairness Caring Virginia Cooperative Extension programs and employment are open to all regardless of race color national origin sex religion age disability political beliefs sexual orientation or marital or family status. An equal opportunity/affirmative action employer. Issued in furtherance of Cooperative Education work Virginia Polytechnic Institute and State University Virginia State University and the U*S* Department of Agriculture cooperating. .