CLARK SCHOLARS PROGRAM
Texas Tech University
 EVALUATION FORM

Applicant should type own name and reference's name and address in the proper place.
Name of Applicant

Reference's Name and Title

Reference's Signature
High School and Address

A. Potential for Success in the Program

                                      

Top 5%   

 Top 10%   

Top 20%

1.  Academic Ability   

2.  Performance
3.  Motivation 
4.  Reliability 
5.  Cooperation
6.  Maturity      
7.  Ability to do Independent Study   
8.  Ability to work with others    

Overall, how does this student rate with current and past students in your classes?
                Top 5%          Top 10%       Top 20%  

How long have you known this student and in what capacity?
B. Remarks:  We would greatly appreciate your subjective evaluation of the applicant's overall qualifications and potential. (Please continue on the back of this page).

Applications must be received by     March 7, 2008  to:
         Dr. Michael San Francisco, Department of Biological Sciences, Box 43131, Texas Tech University, Lubbock, TX 79409-3131.