Reference Form

Washington Community Scholars' Center

Name of Applicant: _______________________

The applicant wishes to participate one of the Washington Community Scholar’s Center (WCSC) urban programs. The Washington Community Scholars’ Center of Eastern Mennonite University is located in Washington, DC. Our programs consists of four key components. Students also have the option to take classes at CUA:

The WSCS weekly seminar focuses on the multicultural history and anthropology of D.C. and grapples with issues of faith with action. Internships help students gain practical skills and career experience working in a job that suits their interests and major. Urban Culture allows students to explore the city of Washington experiencing first hand a diversity of people, lifestyles, religions, and political and artistic expression. Students gain College Credit through weekly seminars, classes at the Catholic University of America and independent study. Group Living with other students encourages sharing perspectives, meals, relationships and common space.

The WCSC is directed by EMU faculty who live in the D.C. area. Your assessment of this person is an important part of the application process. Due to the unique demands of the program, maturity is necessary. Please use the back of this form if extra space is needed. Computer use is encouraged.

Confidentiality: The privacy Act is a Federal Law which states that everyone has the right to know and receive information or copies of documents which are maintained about them by agencies. This law states that WCSC may keep the identity of this reference source confidential only upon your request. Please check one of the following.

____ I do not authorize WCSC to identify me as the source of this reference.

____ I do authorize WCSC to identify me as the source of this reference.

_____________________________________________________________________________

Signed Date

Name (Print):

Address: Occupation:

 

 

Phone:

How long and in what capacity have you known the applicant?

 

 

Personal Characteristics: Program participants live with other students and relate with a diverse population of people at their internships and throughout the city. Please circle "9" as extremely well developed and "1" for very poorly developed.

Emotional Maturity 9 8 7 6 5 4 3 2 1

Self-confidence 9 8 7 6 5 4 3 2 1

Sense of Humor 9 8 7 6 5 4 3 2 1

Integrity 9 8 7 6 5 4 3 2 1

Responsibility 9 8 7 6 5 4 3 2 1

Leadership 9 8 7 6 5 4 3 2 1

Peer Relationships 9 8 7 6 5 4 3 2 1

Please comment on the applicant’s interpersonal relationship skills. Specifically is the person outgoing or withdrawn, what role do they play in a group, are they tolerant, flexible or skilled at listening?

 

 

 

What are the first words that come to mind in describing this person?

 

 

 

Describe any exceptional qualities, special interests and unique experiences of the applicant.

 

 

 

Identify any problems or particular struggles this person may have while in the program.

 

 

 

Academics & Work: The programs of the WCSC demand a great deal from participants, from traditional classrooms at CUA, to taking initiative at internships and during seminar to tackling group life responsibilities. Please circle "9" as very well developed and "1" for very poorly developed:

Self Motivation 9 8 7 6 5 4 3 2 1

Curiosity to Learn 9 8 7 6 5 4 3 2 1

Oral Expression 9 8 7 6 5 4 3 2 1

Written Expression 9 8 7 6 5 4 3 2 1

Work in Groups 9 8 7 6 5 4 3 2 1

Works Independently 9 8 7 6 5 4 3 2 1

Time Management 9 8 7 6 5 4 3 2 1

Dependability 9 8 7 6 5 4 3 2 1

Thoroughness 9 8 7 6 5 4 3 2 1

Integrates Concepts 9 8 7 6 5 4 3 2 1

Please use the space below for any comments regarding the applicant’s work skills and academic ability.

Faith Journey: Comment on the applicant’s participation in church and characteristics of his/her faith.

 

Can you recommend this applicant for participation in WCSC programs?

 

 

Please send this form directly to WCSC, 836 Taylor St., NE, Washington DC, 20017.