Connecticut Roller Derby Cindy Luberto Scholarship for Women Identifying/Non Binary Athletes - 2020 - Recommendation Form
Please provide this form to a coach or advisor who can attest to your athletic participation and provide a brief recommendation for the CTRD Scholarship. This recommendation may be submitted online at www.ctrollerderby.com or may be sent directly to scholarship@ctrollerderby.com.

*Past or current members of CTRD or the immediate family of any current CTRD member are ineligible.
Deadline/How to submit:
* Submit all materials by April 1st, 2020. Application online is at www.ctrollerderby.com, but also may be submitted by email to scholarship@ctrollerderby.com or by mail to CT Roller Derby Scholarship, PO Box 1774, Naugatuck, CT 06770.

Email address *
Student Name *
Your answer
Coach/Advisor Name *
Your answer
Title/Relationship *
Your answer
Years Known *
Your answer
I understand all personal information will be protected and will not be given or sold to any third parties. *
Please briefly describe the applicant's participation in sport(s) and how their passion and performance is unique.
Your answer
A copy of your responses will be emailed to the address you provided.
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