LifeCompass Reference Form

Your Name*
First Last
Email*
Phone Number
Name of applicant you are referring*
First Last
Relationship with applicant*
If you selected other, please explain relationship with applicant:
How long have you known the applicant?*
Would you consider your relationship to be (select one)*
- Very close
- Close
- Casual
- Acquaintance
How have you worked together?*
- Family
- Small group
- Work
- Church
- Social activities
- School
At the LifeCompass program, the applicant will find themselves stretched and challenged in many ways. This could include everything from culture, group living dynamics, heavy study loads, intentional teaching and God stirring up things in their own hearts. Please help us have a better picture of how the applicant may respond in some of these circumstances.
What would you consider the applicant's greatest strength and weakness in light of an intensive gap year program in Asia?*
What do you consider their greatest need for growth, if any, in the following areas:*
Socially Emotionally Spiritually Other

Please rate the following:*

	Unsure	Not their best area	Struggle	Average	Does well	Excel
Follow through
Teachability
Serving others
Study habits
Leadership
Dealing with conflict
Cleanliness in living areas
Group discussions
Time management
Responsiveness to authority
Responsiveness to parental authority
Making friends
Teaching others
Sharing their faith
Personal devotions
Reading ability

Additional information that you feel may be relevant to the items noted in the scale above:
Please describe what growth you have seen in the applicant and two areas where you feel the applicant could grow.
Would you recommend the applicant to be accepted into LifeCompass?*
- Yes
- With hesitation
- No
I consent to my submitted data being collected and stored by Cadence*
- Yes

Socially	Emotionally	Spiritually	Other