Application - Reference Form Step 1 of 3 33% Candidate's Name* First Last Referrer's InformationName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone*Email* How long have you known the candidate?*In what capacity do you know the candidate?*Acquaintance (occasional contact)Casual (some common interest, activities & concerns)Close (discuss specific goals, identify obstacles to achieving goals, creatively work together & support one another to reach goals)Confidant (generously invested in each other's lives - correct on another & point out blind spots) Save and Continue Later CompetencyPlease rate the candidate on the following competencies. Specific observations or insights are appreciated.Self-DevelopmentActively seeks new ways to grow and be challenged using both formal and informal development resources.*UnknownN/ARarelySometimesOftenAlwaysExamples: Shows personal commitment and takes action to continuously improve. Accepts assignments that broaden capabilities. Learns from new experiences and structured learning. Makes the most of available personal/professional growth resources.Comments on Self-DevelopmentDecision QualityMakes good and timely decisions that keep the organization moving forward.*UnknownN/ARarelySometimesOftenAlwaysExamples: Makes sound decisions, even in the absence of complete information. Relies on a mixture of analysis, wisdom, experience, and judgment when making decisions. Considers all relevant factors and uses appropriate decision-making criteria and principles. Recognizes when a quick 80% solution will suffice. Comments on Decision QualitySelf-Awareness/CoachabilityUses a combination of feedback and reflection to gain insight into personal strengths and weaknesses. Is coachable and considers positive outcomes during and after the coaching process.*UnknownN/ARarelySometimesOftenAlwaysExamples: Reflects on activities and their impact on others. Proactively seeks feedback without being defensive. Is open to criticism and talking about shortcoming. Admits mistakes and gains insight from experiences. Knows and owns strengths, weaknesses, opportunities and limits. Comments on Self-Awareness/CoachabilityCollaborationBuilds partnerships and works collaboratively with others to meet shared objectives.*UnknownN/ARarelySometimesOftenAlwaysExamples: Works cooperatively with others across the organization to achieve shared objectives. Represents own interests while being fair to others and their areas. Partners with others to get work done. Credits others for their contributions and accomplishments. Gains trust and support of others. Comments on CollaborationSelf-Motivated & Action OrientedTakes on new opportunities and tough challenges with a sense of urgency, high energy and enthusiasm.*UnknownN/ARarelySometimesOftenAlwaysExamples: Readily acts on challenges, without unnecessary planning. Embraces new opportunities. Displays a can-do attitude in good and bad times. Steps up to handle tough issues. Comments on Self-Motivated and Action OrientedDrives EngagementCreates a climate where people are motivated to do their best to help the organization achieve its objectives.*UnknownN/ARarelySometimesOftenAlwaysExamples: Structures the work so it aligns with other people's goals and motivators. Empowers others. Makes each person feel his/her own contributions are important. Invites input, shares ownership and recognition. Comments on Drives EngagementCandidate's MannerCandidate's manner is constructive, cooperative, positive and optimistic.*UnknownN/ARarelySometimesOftenAlwaysExamples: Approaches work in a positive manner on a regular basis and is optimistic and cooperative.Comments on Applicant's Manner Save and Continue Later Is there any other information you'd like to share with AgForestry about the candidate?Consent* I agree that all information provided is true and accurate to the best of my knowledge.By checking this box, you agree that all information you shared regarding the candidate is true to the best of your knowledge. You understand that this information will be shared with AgForestry staff and the Selection Committee and may directly impact the applicant being selected for the program. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.