American Christian University

| | |

Message Our History Our Vision Our Mission Our University Our Address

High School Extension Minors Bachelor Master Doctoral

.:Partners:.

Friend's Reference Form

Student Information

Name:	(complet name)
Phone:	(Area Code + Number )
E-mail:
Address:	, (address + number)
Complement:	County:
City::	State: Country:
ZIP:

Note : You have the legal right to review all information given from your references after your enrollment at ACU. However, you can chose to waiver your right to keep confidential all information given by the persons you presented as your personal reference. If you decide to waive your right, chek the box below.I do not know
I choose to waive my right to read the information given by my references.

Please, complete the following information usign your best knowledge about the person above:

1. My relationship with this person is:
Employer Supervisor Professor Friend Oter
2. The lengt of time of our relationship is:
Less than one year 1-3 years 3-5 years More than 5 years
3. I know this person:
Very well More or less Casually
4. His (her) Marriage status is:
Single Married Divorced Separated Widow
5. I believe his(her) probability to take the degree with success is:
Very Good Good fair Poor not sure
6. Is this person mature enough to adjust to the school?
Yes No
7. Please, check if this person has used in the last year:
Cigaret Alcohol Drugs None of these
If yes, please explain:
8. Please, check what applies to this person:
Was in discipline or was expelled from the school Was Involved in questionable moral behavior Had law problems
If you checked any box, please explain:
9. I believe this person has special skills, won prizes or demonstrated hig level of eficiency in:

10. I do not have any concern about the honesty and integrity of this person:
Totally Agree Agree Disagree
11. I would rate this person's dedication to God and his(her) devotion to Christian principles as:
Very High Generally High Fair Low, but increasing weak and inconsistent
12. I would evaluate this person's decision to be in the ministry as:
Very Strong Strong weak uncertain

In order to help us to have a better ideia about this person, please evaluate the following areas. Check the number that in your opinion better represents this person in the scale for each following category.

Family History
1 2 3 4 5 6 7 8 9 10 I do not knowi Poor Great

Personality
1 2 3 4 5 6 7 8 9 10 I do not know Introverted Outgoing

Relationships
1 2 3 4 5 6 7 8 9 10 I do not know Meek Angry

Emotional Stability
1 2 3 4 5 6 7 8 9 10 I do not know Instable Very stable

Iniciative
1 2 3 4 5 6 7 8 9 10 I do not know Never Iniciate Auto-motivated

Lidership
1 2 3 4 5 6 7 8 9 10 I do not know Never Leads Consistent, capable to lead

Trustworty
1 2 3 4 5 6 7 8 9 10 I do not know Irresponsable Extremelly responsible

Judgment
1 2 3 4 5 6 7 8 9 10 I do not know Poor Great Discernment

Final Comments:


Your Personal Information:

Name:	(full name)
Position:
Phone:	(Area Code+ Number )
E-mail:
Address:	, (address + number)
Complement:	County:
City:	State: Country:
ZIP:

I would like to receive information about ACU's educational programs.

Thank you for your help.