Supervisor Recommendation Form

Please fill out the form below to recommend your student for the Curious Science Writers Program

Your responses are confidential and will only be viewed by the selection committee. Your honest completion of this form helps us to ensure that candidates accepted into the program have the greatest chance of success. This ensures a valuable experience for the student.

Student Name
First Last
School
School name Address City State / Province / Region ZIP / Postal Code Country
Your Name
First Last
Your position
Email
Phone
How long have you interacted with this student?
Briefly describe the club, organization, or other activity for which you are supervising this student.
Performance rating
Please indicate your confidential rating of the applicant below

This student:

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	n/a
Welcomes constructive feedback
Recognizes a need for guidance and solicits input
Embraces challenges
Participates freely and fully
Balances time; prioritizes competing commitments
Is self-motivated and self-disciplined
Exhibits passion
Is organized and meets deadlines
Works as a team player
Works independently
Asks questions
Respects other’s time
Demonstrates leadership

Do you feel this student is self-motivated and able to independently carry out the tasks required in developing complelling stories while working with a professional mentor?
- Yes
- No
- Not sure
Successful students are those who have a genuine desire to develop science communications skill and are able to adhere to deadlines while communicating effectively with their mentor, content experts, peers and cSw faculty.
Please explain why you chose the answer in the previous question.
Please add any additional comments about this student that will assist the selection committee.

Supervisor Recommendation Form

Performance rating