LTD Reference Thank you for your time in completing this reference form. We thoroughly review our applications and your insights are extremely valuable in helping us discern whether this student can be entrusted in a Christian leadership role with children. Your honest and frank comments are valued. All information will be held in confidence. If you have any questions, please contact Rebecca Machacek. Your Personal Information First Name Last Name Email Address Are you 18 or older?---YesNo Street Address City Province---AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Primary Phone Number Secondary Phone Number About the Applicant Who is the applicant that you are providing a reference for? What position is the applicant applying for?---LTD Program How long have you known the applicant?---Less than 1 year1 - 3 yearsOver 3 years In what capacity/relationship do you know the applicant? How well do you know the applicant?---SomewhatFairly wellVery well What are your thoughts about the applicant? To your knowledge, is the applicant a follower of Christ?---YesNoUnsure What evidence have you seen of their spiritual maturity and relationship with Christ? Would you trust the applicant to care for your children?---YesNoUnsure Please explain your answer to the previous question. What words would you use to describe the applicant as a person? Is there anything else you think we should know?