Bridge Leader Application Reference Form

This form is to be completed by a Smith College faculty/staff member or employer only. The person named below is an applicant for a leadership position in a preorientation program within the division of student affairs. The position's primary responsibilities require a combination of solid interpersonal and organizational abilities. We are interested in those personal qualities that relate to the applicant's ability to mentor first-year and transfer students. Your insights will help us to select the best candidate from the many applicants received.

Your Information

Name
Title
Department
E-mail
Office Phone

Applicant's Information

Applicant
How long have you known the applicant?
My contact with the applicant has been Classroom
Advisee
Other (please explain)

Rate Qualities

In your opinion, how well does the applicant qualify in the following areas?
Intellectual Ability No basis
Average
Good
Excellent
Superior
Character & Personality No basis
Average
Good
Excellent
Superior
Leadership No basis
Average
Good
Excellent
Superior
Motivation No basis
Average
Good
Excellent
Superior
Concern for others No basis
Average
Good
Excellent
Superior
Ability to work well with others No basis
Average
Good
Excellent
Superior
Judgment and common sense No basis
Average
Good
Excellent
Superior
Dependability No basis
Average
Good
Excellent
Superior
Maturity No basis
Average
Good
Excellent
Superior
Self-Discipline No basis
Average
Good
Excellent
Superior
Indicate the strength of your overall endorsement by checking the appropriate space. Highly recommend
Recommend
Recommend with reservation
A written statement, in addition to the completed chart above, is essential to our evaluation of this applicant.

Digital Signature

I certify that all information given in this form is complete and accurate.
Signature
Date