Adult Christian Friend (21+) Reference Form

Adult Christian Friend (21 or older)

*Denotes Required Field
The information given in this Character Reference is used for the application process, roommate placement, as well as allowing us to understand the needs of the applicant. Please answer each question to the best of your ability, and return as soon as possible.
  • yes
  • no
  • yes
  • no
  • yes
  • no
  • above average
  • average
  • questionable
  • no knowledge
  • yes
  • no
  • yes
  • no
  • highly recommended
  • recommended
  • recommended with reservations
  • not recommended
Please rate the applicant on the items below by selecting the appropriate description.
  • not able to observe
  • disrespectful
  • critical
  • respectful
  • shows deference to others
  • not able to observe
  • needs constant supervision
  • needs frequent prodding
  • fulfills ordinary responsibilities
  • self-motivating
  • not able to observe
  • sluggish
  • learns slowly
  • learns with reasonable application
  • learns easily
  • not able to observe
  • indifferent and lazy
  • works in spurts
  • usually fulfills obligations
  • dependable
  • not able to observe
  • stoic and unresponsive
  • moody and temperamental
  • copes well
  • handles stress well
  • not able to observe
  • lacks ability
  • poor judgment
  • fair judgment
  • shows discernment
Relationships (select several)
 ) -
  • Via email
  • Via snail mail
  • I authorize the release of the disclosed information.
  • I do not authorize the release of the disclosed information. (Only select this option if you disagree with the statement below.)
This information will be held in confidence by Peace River Bible Institute and will not be released to anyone (other than appropriate employees or representatives of Peace River Bible Institute), without your permission, or in the absence of your permission, a Court Order, Subpoena or laws requiring the disclosure of such information.

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