(Student:  print 2 copies of this 2-page document.  Distribute to 2 different individuals. Collect sealed and signed documents from your recommender. Mail to address below)

West Valley College/ Native American Scholarship
c/o Michelle Reed
Social Sciences Division
14000 Fruitvale Avenue
Saratoga, CA 95070-5698

(Recommender:  print this letter on your letterhead, place in envelope, seal and sign over seal prior to returning it to the student)

DEADLINE: Friday, Sept. 27

Student's Name: ______________________________________________


Please be specific regarding your knowledge of the applicant. The following information provides a rating chart. Please feel free to include additional information that you feel would be relevant. Please send your completed recommendation form to:

Your recommendation form needs to be received by Friday, Sept. 27

Between what dates has your contact with the student occurred? __________________________

In what capacity has this been? ______________________________________________________

How well do you consider you personally know the applicant?

Very Well _____  Fairly Well _____  Not Very Well _____  Slightly _____
When rating the student, please use the point system below:
0 Inadequate Knowledge
2 Marginal
4 Average
6 Good
8 Excellent
10 Outstanding
ABILITY                                        ____________


LEADERSHIP                               ____________

SCHOOL SERVICE                      ____________

COMMUNITY SERVICE             ____________

EMPLOYMENT RECORD           ____________

OVERALL RATING                      ____________

Comments: Please provide in this section all pertinent information you have regarding the applicant, including character traits and qualities.

Signature of Recommender __________________________________________

Date _________________

Print Name _____________________________________________

Position _______________________________________________

Address ________________________________________________

Telephone # ______________________