Reference Form

If you have trouble with this form, you may also submit this information to Tracey Tevis at tracey_tevis@georgetowncollege.edu.






has applied to be a Student Leader at Georgetown College for the 2014-2015 academic year. These student leader roles can be a powerful time of growth and development for the students involved as well as an opportunity for these students to influence the lives of their peers. Your open, honest responses to the items below will help us make the best decisions.

This student may be applying for the following positions: Resident Advisor, Resident Director, Orientation Leader, Judicial Board Member, Intramural Supervisor, Recreation Supervisor, Campus Ministry Team Leader, Peer Educator and/or Campus Ministry Team.

How well do you know the applicant?
  •  Slightly Fairly Well Very Well
  • How long and under what circumstances have you know the applicant?

Rate the Applicant
  • Please rate the applicant according to the following criteria. If you rate a student a 2 or below, please comment why.
  • 5=Excellent · 4=Above Average · 3=Average · 2=Below Average · 1=Don’t know
  • Leadership

  • The ability to inspire others to coordinate and lead activities; to facilitate group interaction
     5 4 3 2 1
  • Temperament

  • Ability to maintain a positive outlook and realistic perspective; enthusiasm and energy
     5 4 3 2 1
  • Initiative

  • Approach to new situations; self motivation, and ability to set and accomplish goals.
     5 4 3 2 1 
  • Responsibility

  • Degree to which applicant is dependable, prompt and accurate
     5 4 3 2 1
  • Social Sensitivity

  • Sensitivity to and understanding of others apart from self
  • Moral Integrity

  • Ability to tell the truth; adhere to community guidelines
     5 4 3 2 1
Overall Recommendation

  • Any additional comments:

If you have trouble with this form, you may also submit this information to Tracey Tevis at tracey_tevis@georgetowncollege.edu.



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