Reference Request

Applicant Reference Request Form

5567 Painted Rocks Rd | Woodland Park, CO 80863 | volunteer@campelim.com www.campelim.com | 719/687-2030
Applicant Information
Your Name (Applicant's) *

First NameLast Name
Your E-mail (Applicant's)*
Applicant's email address
Referent Information
Referrer's Name*
Name of person you want to request a reference from
Referrer's E-mail*
Email of person you are requesting a reference from
Release: To be completed by Applicant. Please make a selection establishing the confidentiality level or your reference records.*

I waive my right to review these recommendations and hereby establish this as a confidential record.I do not waive my right to review this recommendation and hereby establish this as a non-confidential record.
Attention Applicant: Using this reference request form means you have chosen to waive your right to review this recommendation thereby establishing it as a CONFIDENTIAL record, when you submit this request it will email a reference form directly to your referent. You will not be notified of their response.
Attention Applicant: Using this reference request form means you have chosen to retain your right to review this recommendation thereby establishing it as a NON-CONFIDENTIAL record. When you submit this request it will email a reference form directly to your referent. If they choose to fill out the reference a completed PDF form will be emailed back to you.
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Applicant Reference Request Form

Applicant Information

Referent Information