Reference Letter for BranchOUT Scholarships

The scholarship description and qualifications may be found at LGBTQ Scholarship Information

Deadline is September 30, 2023

Your Reference Letter may be submitted by clicking the submit button below or it may be emailed or mailed/delivered to:

OR

  • LGBTQ Resource Center, Gulfport Library, 5501 28t St. S., Gulfport 33707
Sign in to Google to save your progress. Learn more
Joaquina Ortuno 
Jacob Diaz
131 6th Avenue South
Saint Petersburg
Florida 
33701
7278734826
jacobdiaz@usf.edu 
How long have you known the applicant? 1 year
Advisor to the Latin American Student Association 
Reference

Please use the scale below to rate the applicant:

1: Low/Limited 2: Low Medium 3: Medium 4: High Medium 5: High/Outstanding
Educational achievement 
Clear selection
Participation & Leadership in school and/or community activities
Clear selection
Sense of personal integrity
Clear selection
Positive sense of self as an LGBTQ individual
Clear selection
Service to the LGBTQ community
Clear selection
Jacob Diaz 
Jacob Diaz 
10/11/2023 
Your Reference Letter may be emailed or mailed/delivered by:
  • Submitting this form
  • lgbtqgulfport@gmail.com Subject line: LGBTQ Scholarship Reference Letter
  • LGBTQ Resource Center, Gulfport Library, 5501 28th S., Gulfport, FL 33707
Thank you for supporting this LGBTQ scholarship applicant with your reference!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report