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Student Housing & Residence Life University of Toronto Scarborough 1265 Military Trail Toronto, ON, M1C 1A4

www.utsc.utoronto.ca/~residences

2012-2013 Residence Life/APP TeamReference Form


Name of applicant: _____________________________ Name of reference: _____________________________ Telephone # ___________________ In what capacity do you know the applicant ?_______________________________________ How long have you known the applicant? _____________________________ How well do you know the applicant? Very Well Well Slightly Please rate the applicant on the following areas of competency(please circle) Excellent Average Poor Listening skills Assertiveness Problem-solving skills Shows initiative Organizational skills Ability to see work to completion Leadership potential Time management skills Creativity Ability to express him/herself 5 5 5 5 5 5 5 5 5 5 4 4 4 4 4 4 4 4 4 4 3 3 3 3 3 3 3 3 3 3 2 2 2 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

Please use the back of this form for any additional comments. I certify that this information is true and am aware it will be used in the hiring process. Signature: _________________________________ Date: _________________________ To ensure confidentiality, reference forms are to be sent directly to the address below in a sealed envelope with the referees signature across the back or faxed directly by the referee. RLT/APP Hiring Committee Residence Centre 1265 Military Trail Toronto, ON, M1C 1A4 or Fax (416) 287-7667 Attn: RLT/APP Hiring Committee

All new applications must be received by

MONDAY JANUARY 30, 2012 by 4:00 pm


The University of Toronto respects your privacy. The information on this form is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose of administering admission, registration, academic programs, university-related student activities, activities of student societies, financial assistance and awards, graduation and university advancement, and for the purpose of statistical reporting to government agencies. At all times it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please refer to www.utoronto.ca/privacy or contact the University Freedom of Information and Protection of Privacy Office at 416-946-7303, McMurrich Building, room 201, 12 Queens Park Crescent West, Toronto, ON, M5S 1A8

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