Hartwick College Office of Residential Life & Housing Reference Form
Hartwick College Office of Residential Life & Housing Reference Form
Hartwick College Office of Residential Life & Housing Reference Form
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<strong>Hartwick</strong> <strong>College</strong> <strong>Office</strong> <strong>of</strong> <strong>Residential</strong> <strong>Life</strong> & <strong>Housing</strong><br />
<strong>Reference</strong> <strong>Form</strong><br />
GEB Puppy Raiser/Sitter Candidate Name:<br />
_____________________________________________<br />
The above named candidate has given your name as a reference in connection with his/her<br />
application for a Guiding Eyes For the Blind Puppy Raiser/ Sitter in our Residence Halls. All<br />
comments will be treated in a confidential manner.<br />
Brief description <strong>of</strong> the Puppy Raiser/ Sitter: Teaches the puppy good social skills and house<br />
manners; attends all puppy raising classes and assessments; fills out periodic reports <strong>of</strong> the<br />
puppy; coordinates all health care and veterinary services for the puppy; exposes the puppy to a<br />
variety <strong>of</strong> different experiences; gives puppy up when ready for guide dog training; serves as a<br />
resource person on campus for the Guiding Eyes for the Blind Program; is part <strong>of</strong> the Guiding<br />
Eyes for the Blind campus organization; respects and follows <strong>College</strong> policies in the Residence<br />
Halls; serves as a positive role-model; and shows a well-rounded lifestyle.<br />
► Keeping the above responsibilities in mind, please respond to the following:<br />
1. How well do you know this applicant?<br />
____ Very Well ____ Well ____ Fairly Well<br />
2. If you were in the position to hire this person, would you do so?<br />
____ Yes ____ No<br />
3. Please rate the applicant in the following areas:<br />
Excellent High Average Poor No basis<br />
Ability to relate to others _________ ________ _________ ________ ________<br />
Judgment _________ ________ _________ ________ ________<br />
Adaptability _________ ________ _________ ________ _______<br />
Consideration <strong>of</strong> others _________ ________ _________ ________ ________<br />
Initiative _________ ________ _________ ________ ________
Maturity _________ ________ _________ ________ ________<br />
Responsibility _________ ________ _________ ________ ________<br />
Reliability _________ ________ _________ ________ ________<br />
Ability to communicate ideas ______ ________ _________ ________ ________<br />
4. What is your reaction to whether this applicant should become a Puppy Raiser/ Sitter?<br />
____ Strong Yes ____ Yes ____ Maybe ____ No ____ Strong No<br />
Use this space for further comments. Personal feelings and intuition are appropriate to comment<br />
on. Also include whether this student would be a strong leader among peers in a supervisory<br />
capacity and how aware you think this person is <strong>of</strong> the needs <strong>of</strong> the Guiding Eyes for the Blind<br />
organization and the puppy that he/she would be raising/sitting for.<br />
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Date: ____________________ <br />
Are you (please circle): Faculty Staff Current Raiser/ Sitter<br />
Signature:<br />
______________________________________________________________<br />
Please also print your name:<br />
___________________________________________________________<br />
The student’s signature below indicates that he/she has waived his/her right to see this re<br />
commendation.<br />
__________________________________________________<br />
Student’s signature<br />
Please return this form to:<br />
The <strong>Office</strong> <strong>of</strong> <strong>Residential</strong> <strong>Life</strong> & <strong>Housing</strong><br />
4th Floor Dewar Union
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