Student Reference Form
Thank you in advance for your time and assistance invested in completing this form! Questions may be directed to stm@college-church or (630) 668-0878, ext. 191.
Email address *
Student name *
Reference name *
Reference phone number *
How long have you known this student? *
How do you know this student? *
If other, please specify.
Are you related to this student? If so, please discontinue this questionnaire. Thank you for your time. *
Commitment level and involvement in HYACK small group and large group activities *
Ability to work as a member of a team / servant attitude *
Initiative and leadership skills *
Communication skills / ability to engage others in conversations *
Ability to deal with stressful situations and conflict *
Level of dependability, punctuality and attendance *
Rate this candidate as a potential team member. *
Very weak
Very Strong
Would you recommend this candidate for a student trip? *
If no or maybe, please explain. *
Do you have any concerns you would like to share concerning this candidate and his/her suitability for a student trip? *
Date completed *
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