CBI South | Online Reference Form CBIsouth.com | (770) 736-2828 | 1969 McDaniels Bridge Rd SW, Lilburn, GA 30047 HiddenNext Steps: Install a Payment Add-OnTo accept payments on this form you will need to install one of our payment add-ons. To learn more about your payment add-on options, visit the following page (https://www.gravityforms.com/blog/payment-add-ons). Important: Delete this tip before you publish the form.Prospective Student's NameFull Name(Required) First Last Note to the RefereeThis information will be held in strict confidence. The above-named applicant for acceptance to Calvary Bible Institute has named you as a reference. Your reference contributes to the decision made by our staff regarding this applicant. Therefore, please be thorough and timely in your response. Please complete this form in its entirety.Referee InformationYour Name(Required) First Last Phone(Required)Email(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Church Organization to which you belong:(Required) Position(s) and for how long:(Required)What is your relationship to the student?(Required)Choose OneSenior PastorAssistant PastorChurch/Ministry LeaderFamily MemberFriendOtherPlease describe your relationship to the student:(Required)How long have you known the applicant?(Required) In what capacity have you known the applicant?(Required) How long has the applicant been an active Christian?(Required) Describe the evidences you see in the applicant's life that demonstrates his/her commitment to follow Christ:(Required)Please state any concerns or recommendations that would assist us in the selection of this applicant:(Required)Please choose the appropriate rating on the following questions. Choose "Unknown" if your knowledge of the applicant is insufficient in that area.Responsibility: Ability to faithfully assume and complete duties/obligations:(Required) Unknown Poor Average Good Outstanding Adaptability: Ability to adjust to changes in circumstances:(Required) Unknown Poor Average Good Outstanding Cooperation/Teamwork: Relates well to others in a living or work setting:(Required) Unknown Poor Average Good Outstanding Communication: Able to express thoughts, feelings, and ideas with others:(Required) Unknown Poor Average Good Outstanding Spiritual Maturity: Demonstrates holiness, maturity and consistency:(Required) Unknown Poor Average Good Outstanding Church Involvement:(Required) Unknown Poor Average Good Outstanding Emotional Stability:(Required) Unknown Poor Average Good Outstanding Personal Recommendation:(Required) Unknown Poor Average Good Outstanding Thank you for your recommendation. We will review your answers in confidentiality and make a decision soon. Please sign below and submit the form.Referee Signature(Required) Date(Required) MM slash DD slash YYYY