Leadership and Service Reference
This scholarship is designed to recognize an applicants leadership and service contributions over the last two years. Your reference will serve to verify what the applicant has stated and will help determine the monetary amount of the scholarship. Please be as thorough as possible.
Referee Information
Your Name
*
First Name
Last Name
Your Position
*
Your Organization
*
Name of School or Organisation
Your Phone Number
*
-
Area Code
Phone Number
Your E-mail
*
Relationship to Applicant
*
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Applicant Information
Student's Name
*
First Name
Last Name
Student's previous school(s)
Graduation Year
If applicable.
Please indicate which leadership or service positions the student held over the last two years:
Two years ago:
Over the last year:
Class President
Student Association President
Newspaper Editor
Yearbook Editor
SA/Class Officer
Newspaper Staff
Yearbook Staff
Residence Hall Assistant
Section Leader (Choir/band/orchestra)
Sports Team captain/team officer
Community Organisation position
Church Leader position
Other
Other
Other
Short Answers
For each area checked off above please provide supporting details. A response is required. If the area does not pertain to the student's involvement please write "N/A"
School leadership positions or outstanding service involvement over the previous two years.
*
Please tell us about the student's leadership or service involvement for each position checked off above. Only include positions held over the two years previous to Burman attendance. Include the length of time and a description of the activities and your responsibilities. If none, please indicate N/A.
Community leadership positions or outstanding service involvement over the last two years.
*
Please tell us about the student's leadership or service involvement for each position checked off above. Only include positions held over the two years previous to Burman attendance. Include the length of time and a description of the activities and your responsibilities. If none, please indicate N/A.
Church leadership positions or outstanding service involvement over the previous two years.
*
Please tell us about the student's leadership or service involvement for each position checked off above. Only include positions held over the two years previous to Burman attendance. Include the length of time and a description of the activities and your responsibilities. If none, please indicate N/A.
Were any of the above positions paid employment?
*
If so, please indicate which positions were paid.
If you wish to attach a separate reference letter please do so here.
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