Dance Instructor Reference Form

Dance Instructor Reference

Please fill out all the information below so we can begin processing the applicant's application. The applicant will waive any right to have or obtain copies of this recommendation.
Name of Applicant*

First NameLast Name
Your relationship to applicant:*
Your Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
The above-named applicant has applied to one of the GX International/IWT tours. GX International serves the vision of YWAM Campaigns, an evangelistic-style ministry associated with Youth With A Mission. It features, up to, several nights of performances each week in a city, using sports, extreme sports, dance, media, and music to create a platform to give an evangelistic message. In addition, they go into many schools to give a positive lye message and invite students and their families to the campaign nights. We are seeing many thousands accept Christ on each tour, mostly teens. This team believes in their generation to follow after the Lord with their whole heart and is challenging the youth of today to take a stand for truth and fulfill their destiny in God. In order to adequately evaluate the applicant for these outreaches, we request the following information. Your honesty would be greatly appreciated.
How long have you known this person?*
Which areas of dance has the applicant pursued under your instruction?*
How well does the applicant adapt to new choreography?*
Has the applicant ever choreographed for the group or themselves?*

YesNo
Please critique each dance area:*
Has the applicant at any time proven to be dishonest or of questionable character?*

YesNo
Is the applicant trustworthy and dependable with responsibility given to them?*

YesNo
Additional comments about their character:*
Physical Fitness: (Please check all that apply)*

ActiveAthleticHyperactiveSedentaryHealthySicklyPicky EaterGood EaterDisordered Eating
Do they like to work:*

AloneIn A Group
Has the applicant been an asset to your class?*

YesNo
Is it enjoyable having the applicant work under you?*

YesNo
Temperament: (Check all that apply)*

QuietThoughtfulLovingAntagonisticBoldOutspokenFriendlyOutgoingReservedHelpfulMoodyIndependentBossyEncouragingConsiderateFlexibleNot FlexibleShyIndustriousReliableDiligentForgetfulCarelessOverly SensitiveSloppyCooperativeDramaticNervousFearfulStubbornResponsibleFollowsCreativeSelf InitiatorLazy
Recommendation: What is your overall evaluation of the applicant's involvement with a GX tour?*

Definitely UnsuitedAt This Time Is UnsuitedGood Prospect But I Have Some ReservationsAverage ProspectAbove Average ProspectExcellent Prospect
Comments: Please make any comments about the applicant that will further help us evaluate him or her for participation in GX International.
By signing and writing today's date below,

I understand that this is my signature and thus all information on this reference form is true and accurate.
Name*

First NameLast Name
Signature*
Today's Date*

MonthDayYear
Date
Should be Empty:

Dance Instructor Reference

By signing and writing today's date below,