Recommendation Form — CDF: Supporting Achievement, Honoring Excellence

Student Scholarship Recommendation Form
The Communication Disorders Foundation of Virginia (CDF) is pleased to offer the $4,000 Rita Purcell-Robertson Scholarship, the $4,000 David H. Narburgh Scholarship, and the $3,000 Pat Thomas Dewey Scholarship for the 2025-2026 academic year (to be awarded based on available funding). These scholarships are designed to recognize students who have demonstrated outstanding clinical potential. The three awards will be granted to current or rising full-time (as defined by the university) graduate degree-seeking students (Master’s, AUD or PhD) in Speech-Language Pathology or Audiology enrolled in a Virginia university.

Scholarship Requirements
-The student applicant must be a full-time graduate student (as defined by the university) during the 2025-2026 school year. If the student plans to graduate in December 2025, then full-time attendance during the Fall of 2025 is required.

-All recommendations must be submitted by April 1, 2025.

-The student is required to obtain recommendations from two professionals who have observed the student’s clinical and/or academic skills or has noted personal qualities that predict clinical potential.

-Review and prepare all information required in the form below prior to submission as there is not an option to save your work within the form.

Recommender's Name

First Name

Last Name

Recommender's Email Address

Applicant's Name

First Name

Last Name

Position and/or Relationship to the Student

How long have you known the applicant?

In what capacity?

Please rate the applicant's clinical characteristics

Academic Achievement

Ability to apply theory to practice

Creativity and Flexibility

Initiative and Responsibility

Organizational skills

Professionalism and Responsiveness to suggestions and/or criticism

Self-confidence; Ease and dignity of manner

Oral communication skills

Writing skills

Empathy and concern for others

Cultural responsiveness

Provide specific examples that exemplify how these attributes and characteristics suggest that the student has outstanding clinical potential. (Comments are required.)

Questions? Email Dr. Stacie Raymer, sraymer@odu.edu