Reference / Recommendation Form

"*" indicates required fields

Your Name*

First Last

Contact Email*

Relationship to Applicant:*

Name of meeting (church):*

Your Phone Number*

Student's Full Name*

Grade*

Today's Date*

MM slash DD slash YYYY

The meeting (church) involvement of this child and/or family is:*

Very Active

Somewhat Active

Not Active

This student’s relationship to others of the same age is:*

Blends well

Gets along ok

Does not blend well

This student’s relationship to God seems to be:*

Excellent

Good

Okay

Unsure

This student shows: (check all that apply)*

Initiative

Motivation

Integrity

Influence & Leadership

Concern for others

Do you have additional comments such as strengths, challenges etc.?

I attest that everything I have said above is true.

Signature*

Date*

MM slash DD slash YYYY

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Phone

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Greenleaf Friends Academy
Mailing Address: P.O. Box 368
Physical Address: 20565 Academy Rd
Greenleaf, ID 83626

(208) 459-6346
FAX: (208) 459-7700