General Reference Form

Please evaluate the applicant in the following areas by marking:

5 - outstanding 4 - above average 3 - average 2 - below average 1 - poor N - no information

What outstanding abilities would you say the applicant possesses?

Does the applicant have any personal habits which would disqualify him from becoming an acceptable student? YesNo

Do you recommend this applicant for admission to NTCGS? YesNo

If yes, please check one: with enthusiasmwith reservationwith confidencewith reluctance

Please use this space to give any additional information from above questions or other information which is pertinent.

Name of Reference:

Relationship to Applicant:

Email Address:

Signature:

Date: