FORM III – Staff Recommendation (Confidential) APPLICANT NUMBER____

FORMS I, II, AND III MUST BE SUBMITTED TOGETHER. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED.

Dear Staff Member:

Thank you for taking time to help your student by completing this form. The Council for Exceptional Children – Region One Scholarship Committee requests the following information, pertaining to the qualifications of the applicant, for this year’s scholarship. All information submitted will be treated confidentially.

On what do you base your estimate of the applicant? (Please check)

__________ Personal Acquaintance __________ School Records

__________ Casual Acquaintance __________Personal Observation

__________ Other

Has the applicant maintained a definite and sincere interest in his/her studies?_________

Please add any further information that would help evaluate the student’s application. (DO NOT REFER TO THE STUDENT BY NAME, ONLY AS APPLICANT)

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