For: Summer Internship / Teaching Scholarship

Letter of Reference

(Robert Noyce Teacher Scholarship Program

National Science Foundation)

Instructions: Please type. Save a copy of this document for your files and email a completed form to:

Jennifer Gardner at: .

To be completed by the applicant:

Name of applicant:

Address:

The above named applicant waives the right to review this form at any later date if signed below:

Signature: Date:

(By typing your name in, you agree to all terms of this application)

Letters of reference must be from professional or academic sources. A supplemental recommendation letter may be added to this form, but is not required.

Name of person completing form:

Address:

Phone:

Position/Title:

Employer:

How long have you known the applicant (years & months)?

Under what circumstances have you known the applicant?

Part 1

Summary evaluation: Please use the following evaluation scale to evaluate this applicant:

1 – Outstanding, 2 – Above Average, 3 – Average, 4 – Fair, 5 – Poor, 6 – Not Observed

_______ Academic potential

_______ Ability to work independently

_______ Ability to work with others

_______ Leadership potential

_______ Maturity

_______ Communication skills: ORAL

_______ Communication skills: WRITTEN

_______ Ability to analyze problems and formulate solutions

_______ Social awareness and concern

_______ Motivation for proposed program of study

Part 2

1. What do you consider the applicant’s most outstanding talents or characteristics for becoming a teacher?

2. What characteristics does the applicant need to continue to work on to be successful teaching?

3. Additional comments:

Signature: Date:

(by typing your name in, you agree to all terms of this application)