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
BGCM Staff Recommendation Form
* 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"
* Frequency of member's participation per week
* If other, please list:
* 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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