Homebase Personal Reference Form

If you wish to submit your application by mail or FAX, you may complete and print this form and send it to: Enrollment Walla Walla University 204 South College Avenue College Place, WA 99324 FAX (509) 527-2237
Student Information
* Name of the person you are recommending:
(First, Middle, Last, Maiden)
Social Security Number:
WWU Student Identification Number:
(if a previous WWU student)
Mailing Address:
(if available)
City, State, and ZIP code:
(if available)
Phone Number:
(if available)
Recommendation Information
Please evaluate the applicant in each of the following categories. If you are unfamiliar with the applicant’s performance in a category, mark "not applicable."
(On-line forms cannot be submitted with blank responses in this section.)
* Motivation
* Creativity
* Critical thinking
* Leadership
* Dependability
* Emotional stability
* Ability to work with others
* Personal integrity
* Spiritual maturity
* Overall evaluation
Final Recommendation
* Can you recommend this individual for residence at Walla Walla University?
(please comment if you have any reservations or cannot recommend this individual)
Additional Information
Please add any additional comments you feel would be helpful in your appraisal of the applicant:

Please indicate any area(s) in which the applicant may need special attention from WWU Deans:

Reference Information (Required)
* Your name:
* Your mailing address:
* Your city, state, zip:
Your telephone:
Your e-mail address:
(if any)
Your title/occupation:
* How long have you known the applicant?
* What is your relationship to the applicant?
* Are you familiar with the principles and policies of Walla Walla University?
* To your knowledge, has the applicant ever been convicted of a criminal offense?
Please solve this problem ( why? ): one plus four equals
  * Response required