Reference Form

Please Provide this form to the references you have listed within your scholarship application

Name of Applicant ________________________________________________________________

Reference Last Name _______________________Reference First Name __________________

Educational Institution or Business _________________________________________________

__________________________________________________________________________________

To be completed by reference:

1. How long have you known the applicant?

2. In what capacity?

3. In evaluating this applicant please provide information on his/her personality, character, intellectual ability, community service, or other traits which would otherwise aid/hinder an individual from completing their desired course of future study.

4. Please address additional concerns or comments on the applicant.

Signature: _________________________________________________ Date ________________

Address: ________________________________________________________________________

Additional Contact Info: (e-mail, phone, fax) ______________________________________

Please mail this form to:

Charles and Agnes Kazarian Eternal Foundation/ChurchArmenia.com
30 Kennedy Plaza, 2nd floor
Providence, RI 02903
Attn: Educational Scholarships

Additional comments or questions
e-mail info@churcharmenia.com