Mentor Character/Skills Reference Form Student Name:* First Last The above-named is applying for a tutor position with the University of Georgia’s Athletic Academic Support Department. Your candid evaluation of the applicant will be of assistance to the tutorial coordinator.To Be Completed by the Reference:Name:* First Last Position/Title:* Company/Institution:* Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 Country Phone:*Email:* How long have you known the applicant?* Under what circumstances have you known the applicant?*Please rate the applicant's ability in each area that you have personal knowledge. Number 1 represents the most favorable; number 7 represents the least favorable.Articulate - - - - - - - Inarticulate* 1 2 3 4 5 6 7 Excellent Writer - - - - - - - Poor Writer* 1 2 3 4 5 6 7 Self-Starter - - - - - - - Requires Constant Pushing* 1 2 3 4 5 6 7 Hard Worker - - - - - - - Does Not Work Hard* 1 2 3 4 5 6 7 Honest - - - - - - - Dishonest* 1 2 3 4 5 6 7 Strives for Excellence - - - - - - - Will Settle for Less than the Best* 1 2 3 4 5 6 7 Relates Well to Diverse Groups - - - - - - - Does Not Relate to Diverse Groups* 1 2 3 4 5 6 7 Mature - - - - - - - Immature* 1 2 3 4 5 6 7 Reliable - - - - - - - Unreliable* 1 2 3 4 5 6 7 Organized - - - - - - - Unorganized* 1 2 3 4 5 6 7 Overall, what is your level of recommendation for the applicant?* Strongly Recommend Recommend Do Not Recommend Signature:Please type your name, to serve as an electronic signature, in the event that the signature box above does not work.* Δ
