Applicant Reference Form
You've been asked by someone applying to the Amethyst Recovery Academy to provide a referral on their behalf. This brief form gives you a chance to share your perspective on their readiness for peer support training. We're looking for insight from someone who knows them in a meaningful recovery or professional context — such as a counselor, sponsor, sober house manager, friend, or employer. Your honest feedback helps us ensure a strong fit for the program. Thank you for taking a few minutes to support their growth.
Applicant Information
Who are you filling out the reference form for?
Applicant Name
*
First Name
Last Name
Applicant Email Address
*
Applicant Phone Number
*
Your Information
Name
*
First Name
Last Name
Your Relationship to the Applicant (e.g., sponsor, house manager, etc)
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Organization (if applicable)
Recommendation Questions
How long have you known the applicant?
*
What qualities or strengths does this person bring to recovery work or peer support? Please provide examples.
*
Do you have any reservations about this person participating in a peer support training at this time?
*
Yes
No
If you answered yes to the above question, please explain.
Is there anything else you’d like to share about this person and why you believe they’d be a strong fit for peer support work?
You’re welcome to speak to their recovery journey, personal growth, ability to support others, or anything you’ve seen that makes you confident in their potential as a Peer Recovery Specialist.
If so, share your thoughts below:
Thank you for taking the time to share your perspective!
Your insight plays an important role in helping us build a strong, supportive, and well-prepared community of peer recovery specialists. We appreciate your honesty, thoughtfulness, and support of the applicant.
Submit
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