Reference Form - Global Leadership Program Fall 2018
Personal: To be completed by an adult who knows you well, other than a parent/guardian or relative.

The comments will be used for program selection purposes only. Please digitally sign and date the waiver below.

TO THE PERSON MAKING THIS REFERENCE

The student applicant for the Global Leadership Program has requested that you complete this form as his/her reference. The program leaders attach considerable weight to the statements made by references of the applicant. They are aware of the time necessary to prepare such an assessment and gratefully acknowledge your help.

If your have any questions please contact Alyssa Davis at ADavis@pearlsbuck.org or (858) 531-9124.

Last name *
Your answer
First name *
Your answer
Phone *
Your answer
Email address *
Your answer
Name of student applicant *
Your answer
1) 1 How long and in what capacity have you known the applicant?
Your answer
2) What are the applicant’s primary talents and strengths?
Your answer
3) What is the applicant’s main challenge? *
Your answer
4) Please comment on the applicant’s communication and behavior with his or her peers, if you are able to. *
Your answer
5) Please comment generally on the applicant’s interest in community affairs and potential for leadership. *
Your answer
Please sign and date this application below. *
Your answer
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