2022 Harvard Chan C-CHANGE Youth Summits: Scholarship Educator Reference

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One of your students has applied for a scholarship to attend the Harvard Chan C-CHANGE Climate, Equity, and Health Summits and has indicated that you would be willing to provide a reference on their behalf. Each applicant is carefully selected based on the following guidelines. The scholarship provides full and partial need-based scholarships for underrepresented students and communities to empower the next generation of climate and public health leaders and is designed for students who have a passion for climate change, equity and justice, and/or public health and show a demonstrated interest in climate and/or public health advocacy. To learn more about the Harvard Chan C-CHANGE Youth Summits on Climate, Equity, and Health, please visit: https://precollege.goputney.com/programs/harvard-chan-cchange-climate-program/.

Your reference is a valued and important part of our selection process and your honest response carries significant weight. If you feel uncomfortable recommending the applicant, please email the scholarship coordinator, scholarships@goputney.com, and we will contact the applicant to secure another reference.

All information you provide is confidential. References submitted are read only by the Harvard T.H Chan School of Public Health and the Putney Student Travel scholarship selection committees.

Please complete and submit this reference form as soon as possible. This form should be completed and submitted in one sitting as changes do not save if you navigate away from the page.

Please feel free to reach out with any questions, 802-387-5000 or scholarships@goputney.com

Educator Name, Position, and Name of School: *

Your email address: *

Applicant Name (First and Last): *

How long have you known the applicant? In what capacity? *

How long has the applicant attended their current school? *

Academic standing: Using a scale of 1 to 10, with 10 being the highest possible rating, please indicate how you feel the applicant compares to their peer group as a student in the following areas: Diligence *

To your knowledge, has the applicant ever been involved in disciplinary action, placed on probation, or suspended from school? If yes, please explain *

Are you aware of any emotional, behavioral, or medical issues that may affect the applicant's ability to be an active and constructive member of a group of peers in a residential academic program? *

Please comment on how the applicant would be a constructive and positive member of a group of peers and leaders, who are supportive of one another and open to new experiences and challenges. If you do not believe the applicant would thrive in this type of environment, please let us know. *

If you were leading or teaching at a program such as those described on the Harvard Chan C-CHANGE Youth Summits on Climate, Equity, and Public Health website: https://precollege.goputney.com/programs/harvard-chan-cchange-climate-program/ would you be eager to have the applicant in your group? Why or why not? *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Participation in group settings *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Ease of handling adverse situations *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Inclusion of people and alternate ideas *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Self-direction *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Communication *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Confidence *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Teamwork *

How would you rate the applicant on the following traits in comparison to other students in their peer group? Use a scale of 1 to 10, with 10 being the highest possible rate: Initiative *

Please pick one trait from the list above and briefly describe one example or situation in which the student excelled (or excels). *

Is there anything else you would like us to know? *

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