Willard Hackerman Scholarship Teacher Recommendation Form

Towson University

Applicant’s Instructions: Please complete Section A. Give a copy of this form

Jess and Mildred Fisher College of Science and Mathematics

to two science/math teachers who can assess your academic, scientific, and

other relevant skills and abilities.

Willard Hackerman Scholarship

Recommender’s Instructions: Please complete Section B and sign and return

the form and Letter of Support in a sealed envelope to the student. If you

Teacher Recommendation Form

have any questions, please call 410-704-2121 or e-mail fcsm@towson.edu.

Section A — The applicant completes this section.

1. Applicant’s Name (last, first, middle) Please print.

2. Applicant’s Certification: I certify that I am requesting a recommendation from a science/math teacher of my choosing which will be included in my Willard

Hackerman Scholarship application. My application, including the completed recommendation forms submitted by my recommenders, will be used by the Willard

Hackerman Scholarship Committee to determine my eligibility for participation in the program. I understand that by signing below, I will not have access to this

recommendation, based on the promise of confidentiality provided to my recommender in Section B of this form.

Applicant’s Signature (Sign your full name in ink.)

Date

________________________________________________________________

_______________________________________

Section B — The recommender completes this section.

1. Name and Title of Recommender (Please print)

2. Name of High School, Mailing Address, Telephone and E-Mail

3. How long have you known this applicant and in what capacity?

4. In the table below, please assess the applicant in the listed categories based on your relationship and familiarity with the applicant compared to other students in

the same class year.

Below

Superior

Outstanding

Excellent

Good

Average

No basis for

Category

Average

Top 1%

Top 5%

Top 10%

Top 33%

Top 50%

Judgment

Below the

Top 50%

Ability to complete projects accurately and timely

Writing skills

Analytical problem-solving skills

Rapport with peers

Rapport with faculty

Ability to adapt to new situations

Initiative

Curiosity

Creativity

Observation skills

Effort/Perseverance/Commitment

Overall

5. On a separate sheet please comment on the applicant’s aptitude for science and mathematics, potential for academic excellence, and promise of a career in a

science or mathematics discipline represented at the Fisher College of Science and Mathematics. For example, your comments may include your assessment and

observations of some of the following attributes: interest in science or mathematics, commitment to a scientific or mathematics discipline, engagement in academic

risk-taking behaviors (experimenting, researching, challenging, questioning), creativity, curiosity, initiative, work habits, peer relationships or any of the categories in

the table of question 4.

6. Certification: I certify that the information provided is accurate to the best of my knowledge. I may be contacted by the Fisher College of Science and

Mathematics at Towson University if more detailed elaboration is needed for the information I have provided.

Signature (Sign your full name in ink.)

Date

________________________________________________________________

_______________________________________

Revised 10/2014