Tertiary Education Grant

REFEREES AFFIDAVIT

Students Full Name:

College/University Attending:

Referees Name:

Occupation: Name of Employer/Business:

Business Address: Home Address:

Work Telephone: Home Telephone: Mobile Telephone:

Email:

How long and in what capacity do you know the applicant: ____________ Years
Pastoral/Ministry Leader Academic Reference Justice of the Peace
Other Non-Related Reference (Specify):

Please tell us what you believe to be the applicants particular strengths in personal, educational, or
professional life. If you can, give examples of particular accomplishments

What is your knowledge of the applicants educational goals and progress toward achieving these goals?
Consider any barriers or difficulties she has overcome

Why do you recommend the applicant for this award?

Please sign and stamp with official seal of office/organization to certify this Reference.

Signature & Stamp Date: