Recommendation for MMMF ApplicantAcademic year 2015-16

Deadline for submission: January 15, 2016

Last Name of Applicant (as it appears on passport): __________

First Name of Applicant (as it appears on passport): ___________

Please provide the following information in your recommendation.

Today’s date: Reference Information

Full Name and Title: Street Address: City, State/Province, Zip Code: Country: Phone number: Professional email:

1. How long have you known the applicant (in months or years)?

2. In what capacity do you know the applicant? (i.e. teacher or supervisor)

3. Using the following five criteria - Intellectual Capacity- Seriousness and Perseverance- Leadership Potential- Maturity- Initiative,

assess the applicant's strengths and special talents, involvement in the problems andneeds of women /or children in her country and her commitment to return to her country(200 words or less).

Please save the form as a PDF file which includes the last name of applicant as the file name, and send by email to usc-sc@mmmf-grants.org, from your professional email address. The deadline is January 15, 2016.