STATEMENT OF SUPPORT BY COUNSELORStatement of Support by CounselorStatement of Support by Counselor Applicant's Full Name * I hereby affirm that this application meets the criteria set forth by this scholarship program and that I support this application to RRJr Foundation. I understand all application awards are pending Mile High Continuing Care’s admissions final approval. * I agree Name of Counselor/Faith Based representative submitting the application: * Organization: * Email: * Phone: * Signature of Referral: * Clear Date Submit