professional reference by oM4Qk3H


									                                          FLORIDA NURSES FOUNDATION
                                           2012 SCHOLARSHIP APPLICATION
                                          Professional Reference Form
Section 1 (Completed by applicant)

Please enter the last four digits of your SS#: _______________________________________________

These educational funds are sought to assist in completing a program of study towards a
__________________ degree in nursing at _____________________ College/University.

Section 2 (Completed by Reference)
Please provide a reference addressing academic aptitude, scholarship and seriousness of purpose, clinical
expertise and potential for success in the field of nursing. FNF scholarships are competitive and are awarded on
the basis of scholarship, financial need and the potential for contribution to the profession and society. Please
write your comments below or attach a letter that includes the requested information. Return the reference to the
applicant who will submit it with the application.

This is a blind review process. Please do not include the applicant’s name on this form or any additional letter.
The applicant is responsible for submitting two reference forms to complete the application packet by June 1 . It
is also the applicant’s responsibility to include his/her last four digits of his/her SS# at the top of this page for
identification purposes.

How long have you known the candidate?________ years. In what capacity?__________________

Name (please print)_______________________________________________________________
Signature________________________________________________                             Date________________

            ATTENTION APPLICANT: Please save this document with the last four digits of your SS# and Ref1
   for your first reference form and Ref2 for your second reference form, i.e.2345Ref1.doc and 2345Ref2.doc.
   Email both references to by June 1. If both reference forms and/or reference
   letters are not received by June 1, your application will be deemed incomplete and ineligible.

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