Reference Form

Applicant's Name:

How long have you known the applicant and what is the basis of your relationship? (Pastor, Employer, Teacher, etc.)

                                         Unknown    Weak    Average   Good   Excellent

Level of dependability                                              

Response to authority                                              

Accepts responsibility                                              

Leadership ability                                                    

Emotional stability                                                    

Ethical behavior                                                       

Relationships with                                                    
peers/co-workers

Intellectual ability                                                     

Self-discipline                                                          

Christian faith                                                          

Church involvement                                                 

You are encouraged to add any additional comments concerning the applicant's ability to succeed in an accelerated college program below.

Overall, would you...
Highly Recommend Recommend Recommend with reservations Not recommend
this applicant?


Name:

Address
Street: City: State: AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY Zip:

Phone Number: (xxx-xxx-xxxx)

E-mail Address:

Your help in evaluating this applicant is very much appreciated.