Kentucky Mountain Bible College

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Reference Form

Applicant Information
Your Name (the name of the person filling out this form)*
First Last
Name of Student Applicant for whom you are doing a reference*
First Last
Hidden
Applicant Name - Hidden Check
First Last
This hidden field will store the name of the applicant if one was passed in from an email link.
Knowledge of the Applicant
In what capacity do you know the applicant?*
- Pastor
- Teacher
- Church/Layperson
- Work Supervisor
- Adult Friend
- Other
How well do you know the applicant?*
Approximately how long have you known the applicant?
Years*
Months*
How often does the applicant attend church?*
- Almost Always / Regular Attender
- Frequently
- Occasionally
- Almost Never
- Does Not Attend My Church
Choose the appropriate number according to your knowledge of the applicant.
(1-poor, 2-below average, 3-average, 4-above average, 5-superior, n/a-if unable to answer)
Appearance*
Discreet with Opposite Sex*
Physical Health*
Financially Responsible*
Personal Hygiene*
Spiritually Minded*
Judgment*
Emotional Stability*
Self-Starter*
Dependable*
Leadership Qualities*
Respect for Authority*
Respect for Peers*
Faithful*
Humble*
Self-Esteem*
Self-Discipline*
Honest*
Forgiving*
Cooperative*
Social Skills*
Teachable*
Intelligent*
Integrity*
Mature*
Attitude*
What are the applicant's talents and/or strengths?*
Would you be willing for this person to serve in your church or on a mission field?*
Please share any other information you feel KMBC should be aware of.*
Check the appropriate box regarding the applicant's prospective admission to KMBC.*
I certify that I am not related to the applicant and the information I have provided is true to the best of my knowledge.*
- Yes
- No
Relation Explanation*
Please explain why you selected "no" to the previous question. Please note that KMBC requires recommendations to be from non-relatives, so this form will not be considered as an official reference. However, in certain situations relatives may provide additional information needed by the college.
Signature*
Date*
MM slash DD slash YYYY
Name*
First Last
Hidden
Reference Name - Hidden Check
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Name
This field is for validation purposes and should be left unchanged.

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Reference Form

Applicant Information

Knowledge of the Applicant