Student Reference Form

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STUDENT REFERENCE FORM

The above person has applied at Eden Valley Institute and has given your name as a reference.
Your careful and honest evaluation is valued and necessary for us to make a final decision regarding this individual.
This referral form will be kept strictly confidential.
Since this form must be on file before acceptance can be considered, your prompt completion of this form is appreciated.
Thank you very much for your assistance and for your time in providing us with your honest appraisal of this applicant.

* Indicates required field

Applicant's Name *

First

Last

1. How long have you known the applicant? *

Reference Relationship *

2. Please indicate your description of the applicant's character for each category of evaluation.

Strong Spirituality *

Agree: strong, stable, growing
Neutral: inadequate information about applicant
Disagree: immature, shaky, stagnating

Vigorous Intellect *

Agree: vigorous, creative, learning
Neutral: inadequate information about applicant
Disagree: slow, unmotivated, self-satisfied

Sound Judgment *

Agree: sound, careful, teachable
Neutral: inadequate information about applicant
Disagree: rash, impulsive, headstrong

Compassionate Service *

Agree: compassionate, unselfish
Neutral: inadequate information about applicant
Disagree: indifferent, self-centered

Diligent Industriousness *

Agree: diligent, thorough
Neutral: inadequate information about applicant
Disagree: lazy, incompetent

Loyal Church Relationship *

Agree: loyal, supportive
Neutral: inadequate information about applicant
Disagree: critical, divisive, distant

Conscientiously Healthy Lifestyle *

Agree: conscientious, healthy
Neutral: inadequate information about applicant
Disagree: uninformed, careless

Secure Sociability *

Agree: secure, outgoing, friendly
Neutral: inadequate information about applicant
Disagree: shy, introverted, unsocial

3. What are the applicant's greatest strengths? *

4. In what ways might the applicant need to experience positive growth? *

5. Do you have any information about the applicant's life or background which you believe might be of particular concern to Eden Valley Institute? *

6. Additional comments (optional) *

7. I am acquainted with the principles and policies which characterize life at Eden Valley Institute. *

Yes No

8. Considering the applicant for acceptance at Eden Valley Institute: *

Reference Name *

First

Last

Position or Title *

Date *

Phone Number *

Email *

Submit