Thank you for taking the time to be a reference for this student. This is designed to be quick and easy. Please just complete the form below and press “submit”.


has applied to be a student leader for University Ministries, 2008-2009. She/he has chosen you as a reference and we are requesting your feedback as it relates to their character and potential for leadership. Serious consideration will be given to your responses and this reference will be held in strict confidence.

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Relationship to applicant:



1. Do you have any concerns related to the present spiritual life of this student?
Yes   No   If yes, please comment below:


2. Do you have any concerns about this student as a spiritual leader for their peers?
Yes   No   If yes, please comment below:


3. Do you have any concerns with this student's relationships with peers or authority?
Yes   No    If yes, please comment below:


4. Do you have any concerns related to this student's ability to interact with children, youth, or people from other races/backgrounds?
Yes   No    If yes, please comment below:


5. Do you have any concerns with this student's ability to stay commited and/or over-commit issues?
Yes   No    If yes, please comment below:


6. Do you have any other areas of concern related to this student you feel the need to mention?
Yes   No    If yes, please comment below: