Doneta Schaeffer Memorial Scholarship
Reference for Community Involvement

** Means manditory information- you must fill in that field.

** Applicants Name

You have been asked to complete a reference for the Doneta Schaffer
Memorial Scholarship. Complete this reference and click the submit button
at the bottom of this page to Email this form to: Recognitions@GSEIWI.org.
You can also fill it in, print it off and mail to:

Attn: Doneta Schaeffer Memorial Scholarship,
GSEIWI,
2011 Second Avenue,
RockIsland, IL, 61201.

Letter must be received or postmarked no later than March 1, 2012. Incomplete or late letters will not be considered.

Reference Contact Information

** Means manditory information- you must fill in that field.

** Name
** Street Address (include apt #)
** City ** State ** Zip
Email Address
**Phone (day) **Phone (evening)
** Relationship to Applicant
# of acquaintance years

Doneta Schaeffer Memorial Scholarship Reference Questions

** Means manditory information- you must fill in that field.

** 1. Describe an example of how the applicant has shown leadership in the community. Examples include: community groups, faith organizations, school, sports, etc.

** 2. Describe an example of how the applicant has given service to the community. Examples include: community groups, faith organizations, school, sports, etc.

If you would like to print or save a copy for yourself, you must do so before submitting.
Click on the printer icon on the top right of your webpage to print or go to file and save as.

Press the submit button to email your reference.
Please review your information before submitting.

Doneta Schaeffer Memorial Scholarship Reference for Community Involvement

Reference Contact Information

Doneta Schaeffer Memorial Scholarship Reference Questions

Doneta Schaeffer Memorial Scholarship
Reference for Community Involvement