Name of Applicant
Thank you for taking the time to provide this reference for a Soroptimist Women’s Opportunity Award applicant. This program
gives women the resources they need to improve their education, skills and employment prospects.
To fill out the form:
Select the “Hand Tool,” which appears as a small white hand.
Move the “Hand Tool” and click on the area where you want to type.
A cursor will appear and you can begin typing to complete the form (Note: You will not be able to change the type size.
Please limit your answers to the space allotted.)
Once all parts of the form are completed, select “Save As” from the “File” menu and change the file name (for example,
“ReferenceFormLG.pdf, where “LG” are your initials.) Click “Save.
Email the completed form back to the applicant.
Please use your personal knowledge of this candidate to respond to the following questions:
1. How long have you known the candidate, and in what capacity (employer, school instructor, friend, etc.)?
2. Please rate the candidate in the following areas based upon your knowledge of her achievements and strengths by checking
the appropriate circle.
3. Please tell us what you believe to be the candidate’s particular strengths in her personal, educational, or professional life.
Be as specific as you can, and give examples of particular accomplishments.
Women’s Opportunity Awards
A program of Soroptimist International of the Americas
Strongly
Disagree
Mostly
Disagree
Somewhat
Agree
Mostly
Agree
Strongly
Agree
Don’t Know
A. The applicant is motivated.
B. The applicant has demonstrated a strong sense
of responsbility.
C. The applicant has demonstrated strength in character.
D. The applicant has clear goals.
E. The applicant would be an inspiration to others.
4. What is your knowledge of the candidate’s educational goals, and her progress toward achieving these goals? Consider any
barriers or difficulties she has overcome.
5. Is there any additional information we should know about this applicant in regard to this award program?
COMPLETED BY
(Please email completed reference form to the applicant for submission with her application.)
Name Date
Title Organization
Address
Telephone Email
Address