*Business Name: Enter Business Name * Address: Enter Address

* Phone Number:

Enter Phone Number

* Contact Person:

Enter Contact Person

* Nominee Name:

Enter Applicant Name

* High School:

Enter High School

* Address: Enter Applicant Address

* Phone Number:

Enter Applicant Phone Number

*How long has the Nominee worked for you?

Enter Required Details

*How many hours per week does the nominee work? Enter Required Details * Please describe the nominee's job responsibilities and evaluate their performance: Enter Required Details

Please describe the nominee's performance in the following areas (Rank 1-10; ten being the highest):

* Punctuality: 1 2 3 4 5 6 7 8 9 10

* Conformity to company policies: 1 2 3 4 5 6 7 8 9 10

Attitude: 1 2 3 4 5 6 7 8 9 10

Reliability: 1 2 3 4 5 6 7 8 9 10

Honesty: 1 2 3 4 5 6 7 8 9 10

Teachability: 1 2 3 4 5 6 7 8 9 10

* Ability to work with others: 1 2 3 4 5 6 7 8 9 10

* College that the nominee plans to attend: Enter Required Details * Other comments that make this nominee outstanding: Enter Required Details