Reference Form

Confidential information

Name of the Applicant
Department/ School Selected
Your relationship to the applicant?:*
Employer
Pastor
Friend
Y Leader
Other
If other, please specify *
How well do you know the applicant?*
Very Well
Well
Casually
Since how long you know the applicant?: *
Your Full Name *
Phone *
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    Email *
    Address

    Fill out the information about the applicant:

    Ability to Follow:*
    Superior
    Above Average
    Average
    Below Average
    Leadership:*
    Superior
    Above Average
    Average
    Below Average
    Social Adaptability:*
    Superior
    Above Average
    Average
    Below Average
    Leadership*
    Option 1
    Option 2
    Option 3
    Emotional Stability:*
    Superior
    Above Average
    Average
    Below Average
    Disposition:
    Cheerful
    Average
    Passive
    Mental Ability*
    Quick to Comprehend
    Average
    Slow
    Cooperativeness:*
    Works Well with Others
    Average
    Avoids Group Activities
    Industry:*
    Hard Worker
    Average
    acks Persistence
    Punctuality:*
    Punctual
    Average
    Often Late
    Decision-Making:*
    Superior
    Above Average
    Average
    Below Average
    Health:*
    Superior
    Above Average
    Average
    Below Average
    Concern for Others:*
    Superior
    Above Average
    Average
    Below Average
    Initiative:*
    Superior
    Above Average
    Average
    Below Average
    Personal Appearance:*
    Superior
    Above Average
    Average
    Below Average
    Christian Character:*
    Well Balanced
    Average
    Unstable
    Flexibility*
    Open to Change
    Average
    Unyielding
    Reliability*
    Meets Obligations
    Average
    Neglects Obligations
    Financial Responsibility:*
    Honors Obligations
    Average
    Neglectful
    Do they display high moral standards:*
    Yes
    No
    Are they prejudiced against any group, race, or nationality?*
    Yes
    No
    With reference to their Christian service, do you consider the applicant to be:*
    Dedicated
    Average
    Casual
    Which of the following would best describe the applicant’s Christian experience?*
    Mature
    Contagious
    Genuine and Growing
    Over-Emotional
    Superficial
    What could UofN do to aid the applicant’s personal development? *
    Please comment on the applicant’s family background (If known): *
    Please add any other pertinent remarks (i.e. medical, psychological, drug or alcohol abuse, criminal record, occult practices, etc.). *
    Is the applicant financially responsible? *
    Would you recommend the applicant for acceptance into our campus?*
    Yes
    With Some Reservation
    No
    More comments about the applicant: *
    Please sign to certify that the information given above is accurate. *
    Clear