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 or may be sent directly to

*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, but also may be submitted by email to or by mail to CT Roller Derby Scholarship, PO Box 1774, Naugatuck, CT 06770.

Email *
Student Name *
Coach/Advisor Name *
Title/Relationship *
Years Known *
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.
A copy of your responses will be emailed to the address you provided.
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