Fillable Form 1: Reference writers need to address the (Billings Clinic)

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Form 1: Reference writers need to address the (Billings Clinic)

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1
Billings Clinic Healthcare Scholarship
Recommendation Questonnaire
Please complete your recommendation on this form and carefully follow the instructions.
• Reference writers need to address the question(s) outlined on this recommendation
form.
• Reference writers must date and sign the recommendation questionnaire.
• At least one (1) of the two (2) references must be from an instructor.
• Recommendations from relatives are not acceptable.
• Please save completed questionnaire as a PDF and include applicant’s name.
Example, save as: Recommendation Questionnaire for John Smith
• Email completed questionnaire to sseader@billingsclinic.org
• Include applicant’s name in saved PDF, and email subject line.
Recommendation Questionnaire
1. Applicant’s Name:
2. Your Name & Title:
3. Relationship to applicant:
4. Length of time you have known applicant:
5. Email address:
6. Why should the applicant be considered for this scholarship?
2
7. How has the applicant shown an interest in healthcare?
8. What qualities does this person have which indicate an ability to succeed in the
healthcare field?
3
9. Other Information about the applicant pertinent to this application:
Signature:
Date:
Scholarships are awarded to Individuals who exhibit a strong desire and the potential to excel
in the healthcare field.
Must be postmarked by March 5, 2021. Late or incomplete questionnaire will not be
considered.
Equal Opportunity: Billings Clinic Foundation awards scholarships without regard to race,
religion, creed, age, sex or national origin.
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Form 1: Reference writers need to address the (Billings Clinic)

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Completed 31 January 2021

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