Recommendation Form

Deadline: February 15, 2006

1. Please use a plain piece of paper or your stationery to complete this form.

2. ONLY TYPEWRITTEN OR WORD PROCESSED MATERIALS WILL BE ACCEPTED.

3. The completed recommendation forms should be mailed directly to the Scholarship Fund (not to the applicant or his/her family).  For sample letters of recommendation, please email .

4. Please make sure that your letter includes all of the following:

Applicant Name: ______________________________________

Social Security Number*: ___________________
* Canadian residents please include your Social Insurance Number

How long have you known the applicant and in what capacity?

Please describe the applicant's attitude towards Judaism and why you endorse his/her application for a scholarship to study Judaism in Israel, as well as how would you rate the applicant's altruism.

Are there any special family or financial circumstances that the Scholarship Fund Committee should know about?

Your Name: _________________________________________

Signature: __________________________________________

Please mail this form to be received by February 15, 2006 to:

Dr. Wallace Greene
Alisa Flatow Memorial Scholarship Fund
Post Office Box 4237
River Edge, NJ 07661-4237

Questions may be directed