Reference Form - His Hill Bible School

Reference Form

His Hill Bible School
Your Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Home Address
EmailPhone
Name of Student Applying*

First NameLast Name
How long have you known the applicant?*
What is your relationship to the applicant?*
Extremely WellRather WellCasually
How long has the applicant been a Christian?*
Bible StudyChurch AttendanceChurch ServiceWitnessing
Strongly AgreeAgreeDisagree
The applicant shows particular ability in:*
Ex. Music, serving, leading, etc.
ConsistentFrequentOccasionalSeldom
AgreeDisagreeNot Sure
TobaccoAlcoholMarijuanaNone of the AboveUnsure
BulimiaAnorexiaExcessive Exercise RegimeNone of the Above
Self-Control*

1

2

3

4

5

1 is Very Little, 5 is Very Self-Controlled
Committed Believer*

1

2

3

4

5

1 is Uncommitted, 5 is Highly Committed
Diligent Student*

1

2

3

4

5

1 is Lazy, 5 is Industrious
Teachable*

1

2

3

4

5

1 is Unresponsive, 5 is Highly Responsive
Family Background*

1

2

3

4

5

1 is Poor, 5 is Superior
Personality*

1

2

3

4

5

1 is Withdrawn, 5 is Outgoing
Relationships*

1

2

3

4

5

1 is Abrasive, 5 is Congenial
Emotional Stability*

1

2

3

4

5

1 is Unstable, 5 is Stable
Initiative*

1

2

3

4

5

1 is Never Initiates, 5 is Takes Initiative Easily
Leadership*

1

2

3

4

5

1 is Never Leads, 5 is Leads Well
Disposition*

1

2

3

4

5

1 is Solemn, 5 is Cheerful
Dependability*

1

2

3

4

5

1 is Irresponsible, 5 is Highly Dependable
Judgment*

1

2

3

4

5

1 is Poor, 5 is Discerning
Submits to Authority*

1

2

3

4

5

1 is Disrespectful, 5 is Very Respectful
Personal Appearance and Grooming*

1

2

3

4

5

1 is Unkempt, 5 is Neat
With NO ReservationsWith ReservationsI Do not Recommend
Do you have any additional comments regarding the applicant?
Signature*
Date*

MonthDayYear
Date
All information submitted in this form is considered confidential and will only be discussed to assist the registration team in making an informed decision regarding the applicant's acceptance to His Hill Bible School.
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