Counselling Intern Reference Form

Reference Form Submission Instructions:

We require 3 references for the application, with a min. of 2 that can speak to the applicant within a professional context.

Accepted Professional References:

• A past or current employer
• A superior at work such as a supervisor or manager
• A current or past professor, supervisor, or clinical skills teaching assistant in an academic setting
• A pastor or supervisor in a ministry program familiar with your experience in counselling or related ministries

Please describe the context and relationship that you have with the applicant and how long you've known them for, the applicant's gifts and calling, strengths and weaknesses, past and present areas of ministry, personal and professional issues, and areas requiring development. 

This is to help us understand the applicant's suitability for our internship program.

Thank you for your help. Your prompt response is appreciated.

Sincerely,

Grace Health Centre

To the Referee:

You have been asked to give your opinion of the personal, professional, and academic qualities of the above applicant. Please describe the applicant's qualities, character, ethics, passion and/or report any other characteristics both positive and negative which affect his or her capacity to undertake an advanced internship in counselling.

6. Please comment on the applicant's personality by selecting the most appropriate option from the drop-down menu for each of the following questions:

7. Please complete the personal capacity ratings for the applicant. Please select the appropriate number, with "5" being excellent and "1" being poor. If you do not know enough about the applicant's capacity in a particular area, please leave the question blank.