Kentucky HIMA Student Ambassador Application – Letter of Recommendation Applicant Information Applicant First Name * Applicant Last Name * Reference Contact Information First Name * Last Name Phone Number * primary phone number Additional Phone Number optional Current Address * Street Address City * State * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZipCode * Email Address * Primary Email Address What is your relationship to the student? * Faculty Member Former Supervisor Current Supervisor Colleague Other If "Other", please list the relationship. * Do you recommend the student for acceptance into the KHIMA Student Ambassador Program? * Highly Recommend Recommend Do Not Recommend Please upload your letter of recommendation in PDF Format only. * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB If you are human, leave this field blank. Δ
