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Amity Intern Program -
Reference Form
Name of Applicant:
Please list your name and relationship to the applicant (professor, supervisor, co-worker, etc.).
No relatives or friends please. How long have you known him/her?
(Name)
(Relationship)
(How long?)
Based on your relationship with the applicant, please mark the characteristics that best
describe him/her:
Considerate of others
Initiator of activities
Flexible/Adaptable
Adventurous, likes trying new things
Works well with others
Enjoys being with people
Likes working with young people
Able to communicate well about problems
Prefers to work alone
Perseveres through challenging situations
Personality – Please give a brief description of the applicant’s personality (examples: friendly,
outgoing, serious, shy, etc.)
Professionalism – Please describe the applicant’s ability to work in a professional
environment. Do you feel the applicant will be successful as an educational intern?
Adaptability – Please describe the applicant’s ability to adapt to a new culture/country. Is the
applicant prepared for this type of challenge?
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Reference forms must be signed by hand or electronically using the instructions on the next page. Unsigned
forms will not be accepted. Please submit to .
Name:
Title:
Signature:
Date:
Email: