2018 Action Team Leader Reference Form
This reference should be completed by the applicant's mentor, pastor or supervisor (current or past). References submitted by relatives or peers will not be accepted.

This individual has applied to be an Action Team leader. This commitment involves developing and training a team of undergraduate students in their personal, spiritual and cross-cultural development. Leaders will also be partnering with the Center for Student Action and our in-country hosts to assist the coordination of trip logistics and finances.

Thank you in advance for your honest and critical insight. We will take your evaluation seriously as we consider this individual for leadership. If you have any questions, concerns or additional comments, please contact Laurelyn Shaw in the Center for Student Action at 626-812-3028.

Name of Applicant *
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Your Name: *
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Daytime Phone:
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Email: *
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May we contact you?
In what capacity do you know the applicant? *
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How well do you know the applicant personally? *
How long have you known the applicant? *
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