This award is in memory of
Mary and Michael Follett.
Both were deeply committed to the mission of Monica Place for Pregnant and Parenting Youth
This award is presented annually in June to young women who we have supported in the past or present and who are currently enrolled in a post-secondary program.
Provide to Executive Director:
- A letter outlining your education goals and your reason for applying for the scholarship
- Confirmation of your post-secondary programme
- Completion of Reference Form (available online or from staff) from someone that has known you for a minimum of two years
Follett – Monica Place
Scholarship Award Referee’s Form
- To the Applicant: Complete this section before giving it to the Referee.
Surname _______________________________ Given Names ______________________________________
has been accepted at (Name of Institution) _____________________________________________________
to study in the ________________________________________ programme. Date ____________________
- To the Referee: We appreciate very much the time and effort that you will put into completing this recommendation form. This Award has been created to assist past and present clients of Monica Place in the advancement of their post-secondary education and we are particularly interested to learn your opinion about the potential of the Applicant to benefit from the study programme she proposes.
After completing this reference, please forward directly to:
Monica Place, Attention: Scholarship Award Committee, 231 Herbert Street, Waterloo, ON N2J 1V1,
by Fax (519) 743-0292 or email firstname.lastname@example.org.
(a) How long have you known the Applicant and in what capacity? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
(b) To what degree do you recommend this Applicant be supported in her proposed plan of studies?
□Without Reservation □With Some Reservations (please specify) □Advise Against (please explain)
(c) Please indicate with a ü your ranking of the Applicant in terms of the attributes below.
|Definition of Realistic Goals|
(d) Please add any further comments that would be helpful to the Committee in selecting the Award recipient. Continue on the back or attach an additional sheet if necessary. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
|Name of Referee:||Signature of Referee:|
|Title / Position:||Date:|
|Institution / Employer:||Telephone Number:|