* 1. Name of candidate:

* 2. Your name:

* 3. Your relationship to candidate:

4. How long have you known candidate:

5. Comment briefly on the depth of your relationship to the candidate:

6. Please note the candidate's strengths:

  Never observed Seldom observed Occasionally observed Frequently observed N/A
Consideration of others
Integrity
Flexibility
Awareness
Encouraging
Trustworthy
Role model
Uses good judgment
Effective communicator
Good listener
Team player
Fairness
Creative
Empathetic

7. Other observations about their strengths:

8. Please comment on the candidate's challenges:

9. Describe how you have seen the candidate interact with others in a group.

10. Based on your observations, how willing is the candidate to receive and change behavior based on instruction/feedback?

* 11. Recommend this candidate?

12. Anything else you would like to share or need to share about this candidate?

13. Your signature:

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