ESP SCHOLARSHIP REFERENCE FORM

Please mail or deliver this form to:

Attn: Mayra Martinez

ESP Scholar Program

6300 Ocean Drive, EN 215, Unit 5797

Corpus Christi, Texas 78412-5797

Part 1: tO BE COMPLETED BY the aPPLICANT (STUDENT)

Last Name / First
Banner ID:
Islander E-mail:
Preferred Phone:

permission statement

I hereby authorize the reference named below to complete this personal evaluation form as part of the ESP scholarship application at Texas A&M University- Corpus Christi.
Applicant Signature: Date:

part 2 (a): to be completed by the reference (professor)

Full Name
School Name:
E-mail Address:

Preferred Phone:
Thank you for agreeing to serve as a reference for one of our ESP scholarship applicants.
Your selection as a reference by the candidate speaks highly of you, and your willingness to participate in this important process supports our desire to identify and reward students who are worthy, and deserving of an academic scholarship. Please complete the evaluation from that follows carefully and candidly.
Please send the completed evaluation to the following address:
Attn: Mayra Martinez
ESP Scholars Program,
6300 Ocean Drive, EN 215, Unit 5797
Corpus Christi, Texas 78412-5797

part 2 (b): Confidential reference form

How many years have you known the applicant?
How long has it been since you had the student in class?
What courses or subject did you teach the applicant?

attributes and achievements

In selecting recipients of university scholarships, consideration will be given to an applicant’s academic record and the following attributes and achievements. Please rate the applicant’s relative standing among other students with whom you have had contact on each of the traits listed below. Use the rating scale identified below.

5 / Superior (top 10%) / 90-99%
4 / Outstanding (top 25%) / 75-89%
3 / Above Average (top 40%) / 60-74%
2 / Average (middle 20%) / 40-59%
1 / Below average (bottom 20%) / 01-39%
X / Inadequate opportunity to observe
Enter the appropriate number below, based on the rating scale above and the designed qualities:

socio-economic background information

All students who complete well for academic scholarships have achieved success through hard work and perseverance. Some have achieved success despite socio-economic conditions that may have been a hindrance. Using a rating scale below, circle the number that represents the applicant’s socio-economic background as you know it.
VERY HIGH SOCIO-ECONOMIC BACKGROUND / 1 / 2 / DON’T KNOW / 3 / 4 / VERY LOW SOCIO-ECONOMIC BACKGROUND