This form is to be filled out and mailed separately by one of the following:

Your Principal_____ Grade Advisor_____ College Advisor_____

Be sure to give it to the proper person in plenty of time so we will receive it by May 1st.

Provide him/her with a stamped envelope addressed as above to the attention of the Trustees. If we do not receive all supporting material by May 1st, we will not be able to process your application.

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Student's Name ____________________________________

How long have you known the applicant? ______________

In what connection?

_______________________________________________________________________

Has the applicant ever been suspended? If so, please explain

_______________________________________________________________________

What is your appraisal of the applicant?

_______________________________________________________________________

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Submitted by:______________ (Please Print or Type) Signature:______________ School:______________ Address:______________ Date:______________