California School of Celtic Consciousness Reference Form
To be completed by a teacher, mentor, advisor or religious/spiritual leader who can comment on the applicant's ability to engage the program and participate with the group.
APPLICANT'S last name
Your answer
APPLICANT'S first name
Your answer
REFERENCE'S last name
Your answer
REFERENCE'S first name
Your answer
Phone number
Your answer
Email address
Your answer
How long have you known the applicant?
Your answer
In what capacity have you known the applicant?
Your answer
Please tell us about why you think the applicant would be a good fit for the this School of Celtic Consciousness?
Your answer
Do you have any concerns about this person regarding their participation as a member of the group?
Your answer
Is there anything else you would like to share with us about the applicant?
Your answer
Please sign by entering your name below
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