CCSP Student Affairs Reference

Instructions to Residence Life Assistant, or Residence Life Director:

A student applying to the Creation Care Study Program (CCSP) has selected you to be one of their references. Please know that your recommendation is a vital part of the student’s application process. Thus, your candid comments in the following areas are crucial.

If you are not personally acquainted with the applicant, please either have another student affairs officer who is acquainted with the student complete this form, or fill out this form based on an interview with the student, a discussion with an R.D. or R.A. who knows the student, and a full review of his/her records.

Thank you!

Student's name you are doing a reference for:*

First NameLast NameSuffix

What program are they applying to?

BelizeNew Zealand

Your Name:*

First NameLast NameSuffix

Your institution's name:*

Your Position:*

Phone Number*

Area CodePhone Number

E-mail*

How long have you known this student and in what capacity?*

Level of Christian maturity, commitment and understanding*

How would you describe the student’s maturity and personal character? Please also comment on the student’s emotional stability and social development. *

Applicants to the Creation Care Study Program are asked to commit themselves to the following statement:

I HEREBY RECOGNIZE that I will be participating in a Christ-centered community in New Zealand or Belize, requiring an exemplary lifestyle in living and learning, and respect for members of this community and the surrounding local culture. While in the program, I will endeavor to conduct myself in accordance with a Christ-centered life; cultivating actions it commends such as love, compassion, truthfulness, joy, peace, patience, kindness, goodness, faithfulness, gentleness and self-control. I will likewise refrain from dishonesty, plagiarism, drunkenness, sexual immorality, theft, violence, disruptive behavior, racism, sexual harassment and illicit or non-medical use of drugs, narcotics and other substances. I will also honor any and all additional code of conduct standards required by my home institution.

FURTHERMORE, in respect for the values of others in this community that if my home institution’s code of conduct permits the use of alcohol and tobacco I will abstain from their use on CCSP’s campus, AND at anytime while on CCSP fieldtrips.

I FURTHERMORE DECLARE in respect for the values of others in this community if my home institution’s code of conduct permits the use of alcohol and tobacco I will abstain from their use on CCSP’s campus, AND at anytime while on CCSP fieldtrips.

In your judgment, will this student have difficulty living under this behavioral code? (If the student has ever been on probation for behavioral violations while attending your institution, please explain the circumstances.)*

Additional remarks or other issues we should be aware of*

Your overall recommendation is . . .*

Highly RecommendRecommendRecommend with ReservationDo Not Recommend

Student Affairs Reference: NEW ZEALAND