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Carolyn and Howard Quittner, M.D. and Kelly R. Stewart, M.D. Endowed Scholarship
Scholarship Reference - Carolyn and Howard Quittner, M.D. and Kelly R. Stewart, M.D. Endowed Scholarship

Scholarship Reference – Carolyn and Howard Quittner, M.D. and Kelly R. Stewart, M.D. Endowed Scholarship

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- Carolyn and Howard Quittner, M.D. and Kelly R. Stewart, M.D. Endowed Scholarship
  - Scholarship Reference – Carolyn and Howard Quittner, M.D. and Kelly R. Stewart, M.D. Endowed Scholarship

Student/Reference Information
Student's Name * Required
First Last
Student's Email * Required
Your Name * Required
First Last
Your Email Address * Required

Please provide the same email address that the reference e-mail was sent to.
Position/Title/Credentials * Required

Please let us know where you are employed and your title there.
Please provide a brief description of how you know the scholarship applicant:

Evaluate the Student
Please rate the student with a 1 - 4 on each of the criteria listed below, with 1 being the lowest score and 4 being the highest. If you do not know the student well enough to properly judge them on that criteria, please choose the last option for that question. The final question will allow you to submit any additional comments you feel are appropriate.
ACCURACY: quality of work, amount of supervision needed, precision, technical performance * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
ORGANIZATION: preparation, timeliness of task completion, multiple tasks simultaneously, work prioritizing and sequencing * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
INTEGRITY: acceptance of responsibility, accountability, adherence to department and laboratory polices * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
INITIATIVE: self-reliance, willingness to do extra without being told, motivation, perseverance * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
FOLLOWING DIRECTIONS: procedure manual followed, listening skills, attentiveness * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
DECISION MAKING: use of logic, correct actions from reasoned decision making, appropriateness of questions * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
USE OF RESOURCES: time management, careful use of supplies, materials replenished * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
INTERPERSONAL AND COMMUNICATION SKILLS: ability to work with and help others, cooperation; oral, written, and presentation skills * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
PROFESSIONALISM: behavior, appropriate attire, respectful conduct toward others * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
Adherence to safety policies to protect self and others * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
CARE OF EQUIPMENT AND WORK AREA: performance of necessary maintenance, cleanliness of work area * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
ATTENDANCE AND PERSONALITY: dependability, promptness, reliability * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
RECORD KEEPING: Completeness, legibility, number of errors made * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
MATURITY: confidence, adaptability, stability, response to supervision * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
SERVICE: UAMS and community activities, willingness to volunteer or tutor, participation in special projects * Required
- 4 - Outstanding
- 3 - Above Average
- 2 - Average
- 1 - Below Average
- Do not know enough about the student to evaluate this category
Please provide any other details that you feel may be important for the scholarship committee to consider during the selection process (Optional):
Please digitally sign this form by typing your full name in the space below. * Required
Please enter today's date * Required

Home
- Carolyn and Howard Quittner, M.D. and Kelly R. Stewart, M.D. Endowed Scholarship
  - Scholarship Reference – Carolyn and Howard Quittner, M.D. and Kelly R. Stewart, M.D. Endowed Scholarship

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