All applicants must submit two (2) Recommendation Forms. If you have any questions about this form or the Summer Programs, please contact the STEM Outreach Coordinator, Mrs. Tiffany Green, at (256) 551-7265 or at . Feel free to attach additional statements to this form.

Student Name: ______School: ______

To the person completing this Recommendation form:

The Drake State Summer Programs are four-week, exploratory programs to expose and introduce students to college curriculum leading to rewarding careers in Science, Technology, Engineering and Mathematics (STEM) fields. The student named above has expressed an interest in our Summer Programs. We would appreciate your assessment of the applicant’s readiness for study in a community college environment in terms of leadership, initiative and overall character. If your relationship does not allow you to comment on an aspect of the student’s background, please write “Not Applicable” (or “N/A”) in the space provided. The student is responsible for retrieving and submitting this form to Drake State Community and Technical College.

1.  What is your official job title? ______

I am a r Teacher r Counselor r Coach or r Principal

2.  How long have you know the applicant? Years_____ Months_____

3.  Describe your relationship to this student:______

4.  Check the column that most accurately reflects your sense of this applicant’s characteristics and motivation:

Evaluation Criteria / Strongly Agree / Agree / Agree
Somewhat / Disagree
Positive Attitude
Demonstrates leadership capacity
Self-starter
Highly motivated
Solves interpersonal conflicts well

Recommender’s Information

______

Name (Please Print) Signature Date

______(___)______

Email Address Phone Number