Reference Form

Please send the URL link of this page to your two qualified references so that they may complete this form as quickly as possible.

Applicant Name*
First Middle Last
The above is a candidate for admission to DEERSTREAM, a center of learning for homeschoolers. We would appreciate your evaluation of this candidate. All information on this reference form is confidential.
How long have you known the applicant and in what capacity?*
How well does this student function in a group setting?*
- Very Well
- OK
- May Have Difficulty
Please explain the above answer.
Would you describe him/her as a leader, a follower, a participant, an observer, or a loner?*
How would you describe the student's relationship with both adults and other children?*
Please comment on his/her emotional maturity and integrity.*
How would you describe his/her work and study habits - follows directions well; works independently and in groups; completes tasks?*
Does the student have, or seem to have, any impairment in speech, hearing, vision, muscular development, or visual/auditory perception or processing?*
- Yes
- No
Please help us better understand the impairment.
What advice would you offer to someone working with this student?*
Your Information
for the person(s) providing reference
Name*
First Last
Phone*
Email*
Employer*
Position*
SIGNATURE
By signing below, I affirm that the information provided on this reference is accurate and complete.
Signature*
Please use your mouse or touchscreen to sign in the box provided.
Phone
This field is for validation purposes and should be left unchanged.

Your Information