HTML Preview Nursing Scholarship Reference Letter page number 1.
School of Nursing Scholarship
Western Illinois University
School of Nursing
Currens Hall 125
1 University Circle
Macomb, IL 61455
Phone: (309) 298-2571 Fax: (309) 298-3190
Letter of Recommendation
Applicant’s Name: _____________________________________________________________________
I authorize this reference ______________________________________, to complete this referral sheet for a School
of Nursing Scholarship. I understand that the referral sheet will be forwarded to the School of Nursing Office at
Western Illinois University and will be for the private use of the Scholarship Committee. I will not be permitted to
review this reference sheet for any reason.
Applicant Signature: ____________________________________________________________________
Reference: Please complete this form and return it directly to the School of Nursing Office at Western Illinois University
at the address listed above, prior to May 1
st
deadline. Failure to meet this deadline may jeopardize the applicant’s
opportunity to be considered for this scholarship.
1. How long have you known the applicant?______________________________________
2. What is your relationship with the applicant? ___________________________________
3. Applicant Appraisal
The applicant’s ability to commit and follow through on his/her goals:
( ) Excellent ( ) Good ( ) Fair ( ) Poor
Explain:
How well does the applicant’s past achievements reflect his/her ability to fulfill their
education goals?
( ) Excellent ( ) Good ( ) Fair ( ) Poor
Explain:
4. What qualities make this applicant a good candidate for this scholarship? (please use the
reserve side if needed)
5. Additional Comments – Please add any information which you feel might assist the selection
committee.
Your Name: ______________________________________ Title: _______________________________
Address: _________________________________________ Phone: ______________________________
Signature:________________________________________
If you have questions, please contact the School of Nursing Office (309) 298-2571.