Orientation Team REFERENCE FORM

Name of applicant:

Name of person completing reference:

Title/Relationship to the applicant:

How long have you known the applicant? (Number of months/years):

What is the capacity that you know the applicant?:

How strongly would you recommend the applicant for the Orientation Leader or Orientation Mentor position? (Please explain):

Please indicate the appropriate responses to the following statements. Your level of agreement should reflect the level you feel the candidate displays.

Ability to listen:


Works well with others:

Sensitivity to others:







A desire to learn/grow:

Ability to ask for help:

Emotional stability:


Ability to guide/mentor others:

Effective time management:

Appreciation of others/differences:

Ability to have difficult conversations:

Ability to manage stressful situations:

Ability to meet deadlines:

Please feel free to elaborate on any of the above mentioned statements.

What do you think will be some challenges the applicant will have in the Orientation Leader or Orientation Mentor position?

Please describe your interactions with the applicant that would make them a strong Orientation Leader or Orientation Mentor.


Email: tobey@hws.edu


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