LandSea Leader Reference Form

Please complete and submit this reference form by March 22nd at 5pm. Please feel free to contact OutdoorPrograms@kzoo.edu with any questions or concerns. Thank you for your assistance in the application process.

Reference Form for LandSea Leader Applicant

This reference form is confidential. Thank you for your time. Your candid and thorough comments are an integral part of our evaluation.

"*" indicates required fields

Reference's Contact Information

Your Name *

First Last

Your Email Address *

Your Phone Number *

Applicant Information

Applicant Name *

First Last

Applicant's Email Address *

How long have you known this applicant? *

In what capacity do you know this applicant? *

Please rate the applicant on the following: *

	Poor	Below Average	Average	Above Average	Excellent	No opportunity to observe
Integrity
Confidentiality
Contribution to class or group
Dependability and trustworthiness
Problem solving ability
Willingness to take initiative and responsibility
Potential as a positive role model socially and academically
Ability to handle stress

Please describe this applicant's leadership skills and qualities that you have seen or experienced. *

How has this applicant demonstrated inclusivity and their ability to participate or lead in diverse environments? *

Please speak to this applicant's Emotional Intelligence (Self-awareness, Others-awareness, Empathy, Self-Regulation, Motivation) *

What particular strengths does this applicant have that may serve them as a LandSea Leader? *

What particular weaknesses does this applicant have that may challenge them as a LandSea Leader? *

Additional comments

Your Recommendation *

I recommend without reservation

I recommend with reservation (specify below)

I do not recommend (specify below)

Additional details or specifications in regards to your recommendation above:

Select below if you would like to connect further with one of the program's directors.

I would prefer to discuss this reference further.

Optional: Upload an additional letter of recommendation

Max. file size: 5 MB.

Signature *