Faculty Reference Form

Please complete the following form and click on the Send form button at the bottom of the page when complete.

This unique educational program is conducted as a cooperative effort between the NASA/Ames ResearchCenter and the Foothill-De Anza Community College District. Selected candidates are provided with one-year paid internships. Internship positions are available in a wide range of settings, and correspond to almost everycollege major.

Please give your candid assessment of this student. NOTE: This student has waived his/her rights under the Family Education Rights and Privacy Act. The information will not be disclosed to the student. This reference is confidential. If you have any questions, please call (650) 604-5560.

Student name:
Academic Ability:	Please select Outstanding Above Average Average Poor
Interest in Learning:	Please select Outstanding Above Average Average Poor
Reliability/Attendance:	Please select Outstanding Above Average Average Poor
Initiative:	Please select Outstanding Above Average Average Poor
Ability to Get Along With People:	Please select Outstanding Above Average Average Poor
Oral Communication:	Please select Outstanding Above Average Average Poor
Written Communication:	Please select Outstanding Above Average Average Poor
Willingness to Follow Directions:	Please select Outstanding Above Average Average Poor
Would you hire this student if you had a position for a student trainee? Why or why not?
Please indicate course taught and grade given to this student.
Course:
Grade:
Qtr/Year:
College:
Your email address:
Your Name:
Date: