Lakeshore Youth Leadership Connections Applicant Recommendation Form
Thank you for your participation. The information you provide will help our team select students that best fit the program.
Student Name *
Your answer
Grade Level *
Please select the 17-18 grade level of the student
School *
Please select the school the student currently attends
Recommender Name *
Your answer
Recommender email *
Your answer
Recommender phone number *
Your answer
In what capacity do you know the student? *
Your answer
How long have you known the student? *
Your answer
Ratings *
Please rate the student on the following characteristics as compared to other students at the same education level:
Exceptional
Above Average
Average
Poor
Unable to Rate
Commitment to Learning
Communication - Oral and Written
Time Management
Problem Solving
Responsibility/Dependability
Computer/Technical Skills
Creativity
Additional comments or information you wish to provide regarding the student
Your answer
Summary rating *
Please select one of the following ratings for the student
Electronic Signature *
Please type your name below to certify that all of the answers provided are complete and accurate to the best of your knowledge
Your answer
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