Elite Ambassadors Council (EAC) Referral Form
1. First Name
2. Last Name
3. Age
4. Grade Level/Classification
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5. How long have you known this student?
1-3 years
3-5 years
5-7 years
7-10 years
More than 10 years
6. Please rate the student's skills below (5=highest and 1=lowest)
1
2
3
4
5
Responsibility
Respect
Leadership
Dependability
Cooperativeness
7. Identify at lease 3 of the student's strengths
8. Identify at least 2 of the students' weakness.
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9. Rate your recommendation
Highly Recommend
Recommend as qualified
Recommend with slight reservations
Unable to recommend
10. Your first name
11. Your last name
12. Agency/Organizations/Church you represent
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13. Position
14. telephone Number
Please enter a valid phone number.
15. Email Address
example@example.com
16. If you would like to attach an official letter of recommendation, you can upload it here.
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17. By typing your name below, you agree to recommend this student without any reservations.
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