Trailblazers Reference Form

Name of Applicant(Required)

First Last

Name of Reference(Required)

First Last

Phone(Required)

Email(Required)

Please describe your relationship with the applicant and how long you have known them.(Required)

List three words that best describe the applicant.(Required)

How comfortable is the applicant speaking in front of groups of people?(Required)

Very comfortable. They can confidently speak to and interact with any group.

They can do it, but sometimes it is challenging for them and they like having extra time to prepare.

They do not like it, but they are interested in developing this skill.

How comfortable is the applicant working in a team?(Required)

Very comfortable. They appear to enjoy teamwork and are excited to work with other people on projects.

They can do it, but they don’t always enjoy it and sometimes find it hard to work with others.

They prefer to work on projects on their own, but they are interested in developing this skill.

Choose the one that best describes how the applicant approaches a challenge:(Required)

They embrace it with enthusiasm and determination and enjoy seeking innovative solutions.

They analyze the situation carefully, gather information, and develop a plan of action.

They collaborate with others and seek their perspectives to find the best possible solution.

Sometimes they find challenges overwhelming, but they are interested in improving in this area.

Please rate the following statements on a scale of 1 to 5, where 1 represents "Strongly Disagree" and 5 represents "Strongly Agree":

The applicant demonstrates excellent problem-solving abilities.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant consistently delivers high-quality work.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant effectively communicates ideas and information.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant has strong attention to detail.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant exhibits strong leadership skills.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant collaborates well with others.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant adapts well to changing circumstances and handles pressure effectively.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant consistently meets deadlines and completes tasks on time.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant demonstrates a willingness to learn and develop new skills.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant has strong organizational skills.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant effectively manages and prioritizes tasks.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant takes initiative and ownership of their work.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant has a strong work ethic.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant manages conflicts and resolves issues in a constructive manner.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

The applicant is highly motivated and likes to find new opportunities/activities to get involved with.(Required)
Strongly disagree Disagree Neutral Agree Strongly agree

Describe the applicant's character and integrity based on your interactions or observations.(Required)

Describe how the applicant has demonstrated leadership qualities or potential.(Required)

3. Describe why you think the applicant would be a good fit for this program.(Required)

Describe how you see this program benefiting the applicant’s personal/professional growth.(Required)

Share one specific anecdote or story about the applicant that you believe shows how the applicant cares for others and the environment.(Required)

I attest that I, the reference, completed the reference form independently and that what I provided is true and accurate to the best of my ability.

Today's date(Required)
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