Reference Letter Request Form

This form is to help you provide important information to the Bellerose staff member that you would like to request a reference letter from.

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Email *
Who are you requesting the letter from? *
Full Name *
Pronouns *
Date of Request *
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Date Required *
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Current Grade at Bellerose *
Address *
Postal Code *
What is the reference letter for? *
Provide details about the scholarship/award/job you are applying for.
School Marks
Academic Awards
Post Secondary Plans (include future career goals)
Have you been accepted into a post-secondary course/program?
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If yes, please list the name of the post-secondary institution (include course/program). 
Community Involvement  (clubs, volunteering, sports)

School Activities (include dates)

School Clubs
School Sports (Include Dates)
Hobbies
Leadership Experience
Specialized Training/Courses
Please list any additional information that you would like, or that is required, to be included in your reference letter. 
Contact Phone Number
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