Reference for Scholarship/Honorarium Application Form

This page is to be filled out by the reference for an applicant of a Dillman's Creative Arts Foundation Scholarship and submitted on-line or printed and mailed. The application form is to be filled out by the participant. (required fields)

Name of Reference:
Address of Reference:
Address 2nd line:
City:
State:
Zip:
Country:
Phone:
E-Mail:

 

Name of Applicant:
Address of Applicant:
Address 2nd line:
City:
State:
Zip:
Country:
Phone:
E-Mail:

What is your association with the applicant?

How long have you been associated with the applicant?

 

What is your assessment of the applicant's
 
QUITE
HIGH
ABOVE
AVERAGE
AVERAGE
LOW
Artistic Talent:
Motivation to Learn:
Present Level of Accomplishment:
Chances of Benefiting
from this workshop?
If Applicant is under 21; How will they adapt to living away from supervision?

Comments:


or print and mail to the: Scholarship Committee
Dillman's Creative Arts Foundation, Inc.
Post Office Box 98F
Lac du Flambeau
Wisconsin 54538
DILLMAN'S CREATIVE ARTS FOUNDATION, INC. admits participants of any race, color, sex, age, religion or national or ethnic origin.

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Sunset at Dillman's