Recommendation Form

Applicant, email this document to two non-family members
for their recommendations for your scholarship application(s).

As the area’s primary provider of philanthropic services and scholarships, the Stateline Community Foundation stewards more than 140 charitable funds established by caring individuals, families, businesses and service groups who want to give something back to their community. Since 1986, revenue generated from these endowed funds has provided nearly $8 million in grants and scholarships to cultural, educational and humanitarian programs, exactly as the donors intend.

You have been selected by the student named below to provide your honest assessment of an applicant for a scholarship. Please take the time to express why you believe this applicant would be a worthy recipient. Be as specific as possible, include comments in the areas of academic performance, citizenship, leadership, responsibility, and any other outstanding qualities which come to mind. Please also include in what capacity and for how long you have known this student.

When you have completed this form please,

1. Place it in an envelope
2. Seal the envelope
3. Sign over the seal
4. Return the envelope to the applicant

The applicant will submit their sealed recommendations together with other required documents.
Questions:  Tammy Kerch, tammy@statelinecf.com or (608)362-4228.

Thank you for your time and participation in this process.
Stateline Community Foundation

Applicant Information
(to be filled out by applicant)

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Applicant’s Complete Name Telephone: Home, Mobile,Other

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Address

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City State Zip Email Address

Recommender Information
(to be filled out by recommender)

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Recommender’s Name Title or Position

_____________________________________________________________________
Name of Business or Institution Telephone: Home, Mobile, Other

_____________________________________________________________________
Address

_____________________________________________________________________
City State Zip Email Address

_____________________________________________________________________
Signature Date