2019-2020 Laura Ford Scholarship - Reference Form
Email address *
Technologist / Radiologist reference form
The Laura Ford Scholarship is made available by the Virginia Society of Radiologic
Technologists. In order for the applicant to be considered for Laura Ford Scholarship
this reference form must be completed by 11:59 pm, Eastern Standard Time, December
15th. The time and date is recorded when the form is completed.

Your careful and honest evaluation is appreciated. Please complete all items, including
additional comments which are of considerable value in our evaluation.

Only electronic forms will be accepted. Technology can be challenging so please allow
extra time for technical issues. If you are having any difficulties uploading documentation
contact us at https://www.vsrt.org/contact/

The form must be filled out using your work email address. Thank you for taking the time to
complete this form.

The purpose of this scholarship is to provide financial assistance to students enrolled in a accredited medical imaging program. It is the hope of the Virginia Society of Radiologic Technologists that this will provide individuals with the opportunity and incentive to complete their education in medical imaging field or further their education in a specialty area.
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