Membership Reference Questionnaire

This reference is being submitted by:*
First Last
Applicant's Name
First Last
How long have you known this person?*
What is your relationship to this person?*
On a scale of 1 to 10 (1 being low and 10 being high) how would you rate the applicant on their honesty?*
On a scale of 1 to 10 (1 being low and 10 being high) how would you rate the applicant on their reliability?*
What contributions do you feel this person could make to our station and organization?
Please use this space to provide any additional comments you'd like to share.
Name
This field is for validation purposes and should be left unchanged.

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Long Meadow