Please answer the following questions about the applicant:

    Applicant*:

    Reference Name*:

    Reference Email*:

    1. How long have you known the applicant?

    2. How well do you feel you know the applicant?

    3. Which of the following do you feel best describes how the applicant relates to others? (Select one or more. Use Control key to select multiple entries.)

    4. Which of the following do you feel best describes the applicant? (Select one or more. Use Control key to select multiple entries.)

    5. How would you describe the applicant's temperament? (Select one or more. Use Control key to select multiple entries.)

    How would you describe the applicant in the following areas?

    6. Relationship to their child(ren)?

    7. Emotional stability?

    8. Stability in applicant's marriage?

    9. Family life?

    10. Dependability?

    11. Responsibility and commitment level?

    12. Additional comments? (optional)