Pathways Application Reference Form

Pathways Application Reference Form
An applicant has applied for admission to Pathways Powered by Rocky Mountain College and indicated you as a reference.

We will handle your recommendation seriously and with strict confidence. Please answer the following questions and ensure all required fields are completed before submitting your reference form by clicking the "Submit" button at the bottom of the form.
Applicant's Personal Information
Applicant's Name *

First Name Last Name
Applicant's Email
Reference's Personal information
Reference's Name *

First Name Last Name
Reference's Email *
Reference's Phone Number *

- Area Code Phone Number
Relationship to Applicant *
Reference Form
Does the applicant profess to have a personal relationship with Jesus Christ?

Yes No Unsure
How would you evaluate the applicant's level of spiritual commitment? *

0/200
To what extent is the applicant engaged in church activities? *

0/200
Are you aware of any physical, mental or emotional issues that may affect the applicant's performance in an academic setting? *

0/200
Does the applicant struggle or need assistance in the areas such as: alcohol, tobacco, non-medical drugs, gambling, dishonesty, occult activity, inappropriate movies/videos and/or sexual immorality? *

0/200
Please list the applicant's strengths, as well as any special gifts or talents. *

0/200

Click to edit *

	No Basis for Judgment	Poor	Below Average	Average	Above Average	Excellent
Academic ability
Motivation
Writing skills
Self-discipline
Independence
Creativity
Leadership
Self-confidence
Warmth of personality
Concern for others
Reaction to criticism
Reaction to setbacks
Respect for classmates
Respect for elders
Response to authority
Social readiness for college

Comments to above:

0/200
I certify that to the best of my knowledge all the information on this application is true.

Yes No
Summary and Recommendation:
1. Summarize and assess quality and promise as a college student, such as character, maturity, and personal values. Where does the applicant excel?

0/500

2. I recommend this applicant for admission to Rocky Mountain College: *

	Not recommended	Without enthusiasm	Fairly Strongly	Strongly	Enthusiastically
For Academic Promise
For Character and Personal Promise
Overall Recommendation