Summer Scrubs 2010
  

Teacher Recommendation Form

Online Teacher Recommendation,  or you may click here for Printable version
You may mail your application to Summer Scrubs, P.O. Box 2187, Mobile, AL 36652
or fax to (251) 281-2635.


Student Name:

School:


You have been selected as a reference by the above student applying to participate in the 2010 Summer Scrubs Program.  Your input is very important to us.  We are looking for students who are interested in healthcare, will attend the program each day, and are respectful of others.  All responses will be kept confidential. 

Subject taught/relationship to student:

How long have you known student?

Please rate the student in the following areas:

  5
Excellent
4 Above Average 3
Average
2
Fair
1
Poor
Promptness/Attendance
Academic Achievement
Behavior
Responsibility
Eagerness to learn
Cooperation/Attitude

Do you recommend this student without hesitation to participate in Summer Scrubs?
yes  No

Comments:


Teacher Name: *

Phone Number:  

E-mail address:  * 

                              
*  (required for verification purposes)


REFERENCE MUST BE RECEIVED BY MARCH 19, 2010 FOR STUDENT TO BE CONSIDERED


 

Bay Area Healthcare Coalition
Summer Scrubs is a project of the Bay Area Healthcare Coalition, a volunteer-driven organization of South Alabama healthcare providers and educators, working together to address current and projected shortages of qualified healthcare professionals in our community.

 


The Bay Area Healthcare Coalition is an initiative of the Mobile Area Chamber of Commerce’s Center for Workforce Development