DELEGATE APPLICATION: REFERNCE FORM

To be completed by school official, NGO sponsor or community organization who has known the applicant for a minimum of
one year. Applicants must submit this form along with all other Application Documents in an email to info@girls20.org. Save
this document as follows, using the applicant's information:2016Reference_Country_FirstNameLastName

REFEREE INFORMATION
___________________________________________________________________________
Referee Full Name

Applicant Full Name

___________________________________________________________________________
Referee Email Address

Referee Phone Number (including area code)

___________________________________________________________________________
Name of Organization or School (if applicable)

Referee Relationship to Applicant

APPLICANT ASSESSMENT
1. Assessment of applicants academic ability:
Outstanding

Very Good

Good

Satisfactory

Poor

2. Applicants ability to contribute verbally in a roundtable session in English or Mandarin:

Outstanding

Very Good

Good

Satisfactory

Poor

3. Assessment of applicants knowledge of development issues and current affairs:

Outstanding

Very Good

Good

Satisfactory

Poor

Satisfactory

Poor

4. Assessment of applicants contribution to community service:

Outstanding

Very Good

Good

5. Assessment of applicants level of independence:

Very Independent

Somewhat Independent

Not Independent

6. Why do you believe the applicant would be a good contributor at the G(irls)20 Summit in China?
(Max. 200 words)

G(irls)20 Summit, China 2016

Application Reference Form | 1