DasCHE Reference Check Form
Thank you for taking the time to complete this reference form! One form must be filled out per child in the family. 
Sign in to Google to save your progress. Learn more
Name (your name) *
Email (your email) *
Phone number: *
Name of family you are providing a reference for: *
Student 1 - Name: *
How long have you known this student?  *
In what context have you known this student?  *
Required
Please name 2 positive character traits that you appreciate and have observed in this student: (Two traits must be listed for the reference to be complete) *
Required

Name 1 or more areas below where this student may need work on his/her character development as he/she continues to mature. He/she currently has a tendency toward being: 


 *
Required

In your opinion, would you say that this student: (select at least one)


 *

Based on what you know, would you feel comfortable having your own children spend extended time with this student?


 *

On a scale of 1-10, with 10 being the best, how would you rate the overall Christian character of this student in comparison to others in their age group?

 *
Least
Best

The Scholastic Co-op involves the role of the parent as the primary, homeschool teacher.  On a scale of 1-10, with 10 being the best, how would you rate the relationship between the student and his/her parents in comparison to other families you know?

 *
Least
Best

On a scale of 1-10, with 10 being the best in comparison to other families you know, would you say that this family is easy to get along with, easy to work with, and is cooperative in a group setting with other families (ie, church, athletics, group functions, etc)?

 *
Least
Best

Is there any additional information about this student or his/her family that you feel would be helpful regarding their admission to the Scholastic Co-op? (If no, please type N/A)

 *
By typing your name below, you agree that this constitutes your electronic signature.   *
Date: *
MM
/
DD
/
YYYY
If there are multiple children, please use the "submit another response" on the next page to complete a form for the next child.  
Thank you!
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dallas Christian Home Educators. Report Abuse
Google Forms