REFEREES QUESTIONNAIRE

To assess the suitability of the applicant for residence, please complete and return directly to " The Manager, Baptist Student Hostel, 163 Fitzherbert Avenue, Palmerston North."

Applicants Name: 
Name of Referee: 
Address of Referee: 
Telephone: 

1. How long have you known the applicant.

2. State your relationship to applicant.

3. What has been the nature and frequency of your contact with the applicant?

4. As a potential resident the applicant will be part of a community of 32 people. How do you assess the applicants:
a. Ability to relate to other people?

b. Capacity to contribute to the life of the Hostel?

c. Willingness to adapt to a structured environment?

d. In what way do you think the applicant would benefit from living in the Hostel?

5. Has the applicant any unusual personal characteristics or disabilities?

6. What do you know of the applicants Christian Commitment and involvement is church related activities?

7. What other interests, sports hobbies or skills does the applicant have?

8. Any other comments that you think might assist the board in coming to a decision

Signed Date