La Vida Intern Reference Form
Applicant's name
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First Name
Last Name
Your name
*
First Name
Last Name
Your phone number
*
Please enter a valid phone number.
Your email
example@example.com
How long have you known the applicant?
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How do you know the applicant (in what capacity)?
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Please rank the applicant's leadership potential.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's emotional maturity.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's judgment and decision-making skills.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's work ethic.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's integrity.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's communication skills.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's ability to work with others.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's dependability.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's ability to grow and/or learn new skills.
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Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Please rank the applicant's faith commitment.
*
Please Select
Excellent
Above average
Average
Below average
Poor
Unable to say - please clarify below
Share any clarifying comments you have for the above responses.
Listed below are traits that may limit the applicant's effectiveness in some positions. Please check any traits you have observed in the applicant. (The presence of these traits will not automatically disqualify an applicant from a leadership position.)
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Argumentative
Cocky
Controlling or domineering
Easily depressed
Easily discouraged
Easily embarrassed
Easily irritated
Frequently worried, anxious, or nervous
Given to exclusive and absorbing relationships
Impatient
Inflexible
Lazy
Prejudiced toward groups, races, or nationalities
Very critical or jokingly critical
Withdrawn or overly quiet
Other - please explain below
None observed
Share any clarifying comments about traits checked in the previous question.
What are three of the applicant's strengths?
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What are three areas in which the applicant needs further development?
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What leadership traits does this applicant possess?
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La Vida interns have responsibility for programming, team-building, adventure activities, working with peers, and being a role model. Based on your knowledge of the applicant, please explain how you feel that he or she would perform in a leadership position.
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Do you recommend this individual for a position with the La Vida Intern program?
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Please Select
Strongly recommend
Recommend
Recommend with reservations
Do not recommend
Do you have any additional comments you would like to share?
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