student personal reference form Student Name * First Name Last Name Program Applicant is Attending * Saskatchewan British Columbia Reference Name * First Name Last Name Reference Relationship to Applicant * Reference Email * Reference Home Phone Number (###) ### #### Reference Cell Phone Number * (###) ### #### How long have you known the applicant? * How well do you know the applicant? * By Name Casually Fairly Well Very well Do you consider this student mature for his or her age? Why or why not? * How well does this student work as part of a team? What have you seen in his or her character andattitude when serving and working with others? * Does this student respond well to authority figures? If no, can you please briefly explain asituation in which this was an issue with the student? * Does the student have any mission experience (international or in Canada) or any other ministry/workexperience that would have prepared them well for this mission? * To the best of your knowledge, does this student experience any mental or physical health issuesthat would prevent or make it difficult for them to be successful on this mission? *Physical and mental health issues will not be used to discriminate against students. However, they must be considered for the safety of the studentand the ability for the student to participate in the mission. For example, if a student has broken their leg and cannot walk for the summer, but theinternational mission requires students to walk for all transportation during the mission, it is unfair to send the student on this team and he or sheshould be encouraged to apply again next year.* Please rate the following character traits of the student: Applicant Adaptability * Excellent Above Average Average Poor Unknown Applicant Dependability * Excellent Above Average Average Poor Unknown Applicant Leadership Abilities * Excellent Above Average Average Poor Unknown Applicant Servanthood * Excellent Above Average Average Poor Unknown Applicant Spiritual Life * Excellent Above Average Average Poor Unknown How often does the applicant display these characteristics: Applicant Procrastinates * Often Sometimes Rarely Never Unknown Applicant Critical * Often Sometimes Rarely Never Unknown Applicant Irritable * Often Sometimes Rarely Never Unknown Applicant Inclined To Romantic Crushes * Often Sometimes Rarely Never Unknown Applicant Depressed * Often Sometimes Rarely Never Unknown Applicant Argumentative * Often Sometimes Rarely Never Unknown Applicant Domineering * Often Sometimes Rarely Never Unknown Applicant Rebellious * Often Sometimes Rarely Never Unknown Do you have any concerns about sending this student on this mission that you believe would behelpful to the Street Invaders leadership team in deciding if this student will join this team? * What are a few strengths this student can contribute to Street Invaders? * Based on the information you have shared with us, would you recommend this student to be involved with Street Invaders this summer? * Strongly Recommend Recommend Recommend with Reservation Not Recommended We would appreciate any additional comments you might have concerning the applicant: Thank you!
