APPLICANT
PEER
REFERENCE
This reference is to be completed by an individual who has lived with you or is very close to you.
May not be a relative, spouse, partner, or significant other.
Thank you for providing reference information as part of the application process to Border Servant Corps. Your open and honest responses will assist our efforts to be more sensitive to the applicant’s abilities and needs, service placement, and compatibility in community living. This information is confidential.
APPLICANT INFORMATION
Name of Applicant: ______
APPLICANTREFERENCE
How long and under what circumstances have you known this applicant?
Describe the applicant’s strengths.
In what areas does the applicant have room for growth?
How does the applicant interact with others from a different background?
How does the applicant respond to directives from peers or supervisors? How does the applicant respond when s/he disagrees?
For what type of work is the applicant best suited – direct social services, community organizing, indirect social services, public policy/advocacy? Why?
BSC’s four tenets are community, simplicity, social justice, and spirituality. Please speak to any experience you have had with the applicant that highlight their commitment to any/all of these values.
Please indicate which of the statements in each pair below best describes the applicant. If you have not observed the applicant in this situation, please leave that pair blank.
_____ Excels with group work
_____ Excels with independent work
_____ Enjoys a changing pace
_____ Enjoys a steady pace
_____ Excels with close supervision
_____ Excels with less supervision
_____ Likes to initiate projects
_____ Likes to carry out projects
_____ Likes to have a cyclical routine of
assignments
_____ Likes assignments to vary each day
_____ Seeks interaction with the public
_____ Prefers limited contact with the public
_____ Processes thoughts, preferences,
and ideas internally
_____ Processes thoughts, preferences,
and ideas externally
INTERPERSONAL SKILLS
Check the box that you feel best describes how the applicant typically behaves on most days, on most projects, and with most people. / Almost Always / Usually / Occasionally / Rarely / Almost Never / Unable to Assess / CommentsExhibits healthy sense of humor
Demonstrates integrity
Thoughtfully uses resources (such as time, money, technology, etc.)
Knows own limits
Is open to discussing one’s faith and beliefs
Interacts well one-on-one
Interacts well in groups
Addresses conflict in a timely manner
Is active in addressing social/environmental concerns
Displays flexibility in addressing difficult or unexpected situations
Is tactful
Cares for own needs
List three adjectives that best describe the applicant:
1: ______2: ______3: ______
Please comment on any other aspects of this applicant that might be relevant.
At what level would you recommend this applicant for acceptance into BSC?
_____ Weak, should be discouraged
_____ Good, better than many
_____ Very good, no reservation at all
EMPLOYER/SUPERVISORREFERENCE INFORMATION
By initialing below, I attest that the information provided is complete and accurate to the best of my knowledge:
Initials: ______Full Name: ______
Title: ______Organization: ______
Complete Address: ______Work Phone: ______
Would you like to be added to BSC’s online mailing list (unsubscribe capability enabled)?
_____ Yes, please._____ No, thank you._____ Thanks! I already receive it.
Would you like to have a BSC representative speak to your organization?
_____ Yes, please._____ No, thank you._____ Thanks! I’m already in contact.
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