Admissions Reference Form

First Name: (required)

Last Name: (required)

Phone Number:

First Name of Applicant: (required)

Last Name of Applicant: (required)

How long have you known the applicant? (required)

In what context / relationship do you know the applicant?

In the drop-downs below, which phrase best describes the applicant?

Desire to Learn
---Strong determinationPositive attitudeNeeds encouragementShows little interestNo opportunity to observe

Leadership
---Excellent leadership initiativeGood organizerLeads when askedMakes little effort to leadNo opportunity to observe

Cooperation
---Works well with othersUsually cooperativeAvoids group activitiesCauses frictionNo opportunity to observe

Respect for Authority
---Respects those in authorityGenerally respectfulCritical of authorityDisrespectfulNo opportunity to observe

Concern for Others
---Unselfish caringConsiderateIndifferentSelf-centeredNo opportunity to observe

Acceptance by Peers
---Well liked, sought by othersWell acceptedToleratedNot acceptedNo opportunity to observe

Emotional Stability
---Consistently stableUsually well adjustedSometimes unstableUnbalanced, unstable, emotionalNo opportunity to observe

Energy and Initiative
---Seeks additional tasksDoes more than expectedDoes assigned tasksNeeds proddingNo opportunity to observe

Spiritual Motivation / Energy
---High moral & spiritual valuesConsistent moral standardsInconsistent attitudes & practiceNot aware of spiritual beliefsNo opportunity to observe

Does the applicant possess any special interests or abilities?

Does the applicant have significant limitations that would hinder college study?

Please enter any additional comments you would like to make below:

Do you recommend the applicant be accepted for admission to Alaska Christian College?
I recommendI do not recommendI recommend with the following reservations

Please sign and date below

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