The Delta Kappa Gamma Society International	
Alpha Rho State Oregon
Scholarship Reference Form
Applicant’s name	
Personal Qualities	Upper 1/3	Middle 1/3	Lower 1/3
1.	Shows evidence of good health		
2.	Shows care in personal appearance		
3.	Displays emotional stability		
4.	Demonstrates ability to work with people		
5.	Adjusts readily to new situations		

Professional Qualities 	Upper 1/3	Middle 1/3	Lower 1/3
1.	Participates in advancement of education		
2.	Is punctual in her responsibilities		
3.	Has the ability to express herself orally		
4.	Is well organized		
5.	Follows administrative policies		
6.	Maintains good rapport with students		
7.	Has the ability to put ideas, concepts and
 directives into written form		
8.	Uses a positive attitude in her everyday
relationships with others		

Comments:

	
Signed:	Position	Date
Due dates, same as applications: August 1, December 1, and March 1. 
Mail to: Jill Lang, 16301 SE Katie Ct., Milwaukie, OR 97267-5198,  503-786-7268 jaceel@comcast.net