BGCM Scholars
* - Required field

Applicant's Information
* Please select type of reference letter to submit
* Scholar First Name
* Scholar Last Name
Your Information
* First Name
* Last Name
Phone Number
Email Address
Affiliation
Title
Applicant Abilities
On a scale from 1 to 5 (lowest to highest)
How confident are you in the applicant's ability to be successful in college?
What actions has the applicant taken to ensure college success? What specific actions have you observed by this applicant?
Should the applicant remain local for school or would you be confident the student would do well at an out of state institution? Explain your position?
Is there any additional information you would like to share about the applicant?
Additional Information
* Club Location
How long has this student been a Club memberCheck Club-Kidtrax to find the "Initial Service Date" Check Club-Kidtrax to find the "Initial Service Date" Check Club-Kidtrax to fine "Initial Service Date"
How long have you known the applicant?
In what capacity do you know the applicant?
In your opinion, how motivated do you feel the applicant is about attending college? Why do feel this way?
* Frequency of member's participation per week
* If other, please list:
What are your biggest concerns for the applicant as they transition to college life?
* Frequency of member's attendance in past 12 months
Frequency of Member's Participation in last year
* List 3 programs this member participated in during your tenure with the Club
* What obstacles have you observed this member overcome?Please limit responses to 500 characters
* Please provide a brief statement of the member's volunteer activities at the ClubPlease limit responses to 500 characters
* If awarded a scholarship, how do you think he/she will use their education to serve BGCM and the community?Please limit responses to 500 characters
Other Recommendation Letter
INSTRUCTIONS GO HERE
* Recommendation
Agreement
By checking the "I Agree" box I have agreed to submit this application by electronic means. In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. Falsification of information may result in termination of any scholarship granted to the scholarship applicant. I understand the penalties for giving false information or breaking the rules.

* I Agree
By signing this application electronically, I certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge. I also certify that: I understand the questions and statements on this application. I have read and understand the legal information. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

Date
* Signature
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