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Provide a Reference (LGJ or YLJ)
Step 1 of 3 - Applicant Info
33%
Name of Applicant
*
First
Middle
Last
Address of Applicant
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Name of Reference
*
First
Middle
Last
School/Firm/Organization
*
Position/Title
*
Address of Reference
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
*
For how long and in what capacity have you known the applicant?
*
What do you consider the applicant's primary talents or strengths?
*
What do you consider the applicant's chief weakness?
*
Comment on the applicant's relationships with his or her peers.
*
Applicant's grade point average is _____ on a _____ point scale.
(This question should be answered only by the reference who is the applicant's principal/ headmaster or counselor.)
GPA
Point Scale
Additional Comments
*
Please comment on the applicant's ability to communicate with others, his or her behavior in a group setting (participant or observer?), interest in community affairs and potential for becoming a community leader.
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Character
*
How would you compare the applicant's
character
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Concern for others
*
How would you compare the applicant's
concern for others
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Responsibility
*
How would you compare the applicant's
responsibility
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Leadership
*
How would you compare the applicant's
leadership
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Initiative
*
How would you compare the applicant's
initiative
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Curiosity
*
How would you compare the applicant's
curiosity
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Ability to Work with Others
*
How would you compare the applicant's
Ability to Work with Others
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Maturity
*
How would you compare the applicant's
maturity
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Poise
*
How would you compare the applicant's
poise
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Oral Communication Skills
*
How would you compare the applicant's
Oral Communication Skills
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Persistence and Drive
*
How would you compare the applicant's
Persistence and Drive
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Interest in Community Affairs
*
How would you compare the applicant's
Interest in Community Affairs
with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Analytical Ability
*
How would you compare the applicant's
Analytical Ability
(e.g., ability to explore problems in an orderly manner and generate alternatives) with other high school sophomores or juniors you have known?
Exceptional
Excellent
Good
Average
Poor
Unable to Judge
Comments
This field is for validation purposes and should be left unchanged.
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