Reference

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DeChiaro College Center
Ground Floor, West Wing
phone: 410-617-2232
thecareercenter@loyola.edu

Internship Challenge - Reference Form

Fields marked with * are required.

Description:*

Contact Information

Applicant's First Name*

Applicant's Last Name*

Applicant's email Address:*

Note: This is for confirmation only, a copy of the reference will not be sent to the Applicant.

Reference First Name:*

Reference Last Name:*

Reference's Address/Contact info

Relation to Applicant: *

How long have you known the Applicant:*

Applicant Ratings

Ability to take initiative:*

Ability to work hard - beyond what is necessary:*

Openess to trying new things:*

Ability to work with a large group:*

Organizational skills:*

Intellectual and Intuitive skills:*

Leadership skills:*

If you selected poor for any of the above please explain:
Please indicate a key or unique quality of the Applicant:
Please indicate one area in need of personal development:

What is your recommendation for this student to be accepted into this program and ultimately for an internship?*

Any further comments?

Signature

Digital Signature*

Please enter in your full name as this will act as your digital signature.

Position and title:*

The Current date is

The Current time is