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Updating...
Confidential Reference
To be filled out by
the
referee of applicant to Shalom College. Family friends may NOT serve as referees.
Please click
here
for a downloadable version of this form
Applicant Details
First Name:
*
required
Family Name:
*
required
Referee Details
First Name:
*
required
Family Name:
*
required
Institution/ Company:
*
required
Position:
*
required
Referee Details
Address:
Street no:
*
required
Street Name:
*
required
Suburb:
*
required
State:
*
required
Country:
*
required
Postcode/ Zip:
*
required
Email Address:
*
required
Phone Number
Phone Number
Country Code
*
required
Area Code
*
required
Number
*
required
Referee Details
Phone Numbers (Please include country and area codes).
Mobile/ Cell:
*
required
Business Number
*
required
In what capacity to do you know the applicant?
*
required
How long have you known the applicant?
*
required
Does the applicant have any outstanding qualities? If so, please explain:
*
required
What would you regard as areas requiring further maturity or development in the candidate?
*
required
How do you think the applicant would cope with the demands placed upon him/ her in a residential environment?
*
required
Please rate the applicant in comparison with others of his/her age and position whom you know with regard to his/ her:
Ability to relate to others:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Consideration for others:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Integrity:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Maturity:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Emotional stability:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Common sense and judgement:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Leadership qualities:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Intelligence & academic potential:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Ability to express ideas
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Organisational ability:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Application to study:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
How she/he handles disappointment:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Extra-curricular activities:
*
required
Outstanding
Better than most
As good as most
Not as good as most
Not able to comment
Any additional comments you would like to make about the applicant?
*
required
Mandatory field(s) marked with
*
required
Form Field:
Type
*
Caption
*
Input Limit
*
Input Box Width
*
Rows
*
List Options
Email Routing
(for above list options)
Link Options
(from previous question options)
Options
Depends On Answer
Available Answers
Add Option
Delete Option
Add
Remove
Multiple selection
Mandatory field
No Validation
Allow numbers [0-9] only
Allow alphabets [a-z,A-Z,space] only
Allow alphanumeric [a-z,A-Z,0-9,space] only
Allow Names [a-z,A-Z,dash,single quote,space] only
Pre-populate with user field
None
Title
First Name
Last Name
First and Last Name
Email Address
Logon
Company Name
Web Site Address
Phone Area Code
Phone Number
Fax Area Code
Fax Number
Mobile Number
Physical Address Line 1
Physical Address Line 2
Physical Address Line 3
Physical Suburb
Physical State
Physical Postcode
Mailing Address Line 1
Mailing Address Line 2
Mailing Address Line 3
Mailing Suburb
Mailing State
Mailing Postcode
Products and Services
Marketing Message
Group
OR
CC on submitted data Email
Use as From Address on Email
Exclude field from Email
Include answer in Email Subject
Hidden field (1st submission)
Set as Heading (for viewing
form responses)
(* = mandatory field)
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