Reference Form

Applicant Details

Applicant Name *

Company *

Your Details

Name *

Email Address *

Current Company/Organization *

Current Position *

How do you know the applicant? *

How long have you known the applicant? *

Items to consider when writing this reference:

How well do you know the applicant’s professional work?
Please comment on the applicant’s contributions to your organization or you personally.
Please comment on the applicant’s competency in his/her industry.
Relative to other individuals at the same level in the industry, please indicate an overall assessment of the applicant’s ranking.

In your opinion, how well does the applicant’s professional experience equip him/her to coach, train or consult with an organization or individual? *

To your knowledge does the applicant have any other qualifications relevant to this application? *

Do you have any other comments on this applicant’s application for Charter KII® Partner? *

Please rate the applicant on the following skills and qualities: on a scale from 1-10 (10 being the highest)

Communication Skills *

Learning Ability *

Honesty *

Truth-Telling Ability *

Work Ethic *

Determination & Persistence *

Willingness to Add to Knowledge Base *

Problem-Solving Skills *

Leadership Skills *

Motivation *

Approachable *

Loyalty *

Follow-Through *

Ability to Accept Feedback *

Cooperative *

Note: All reference material is kept confidential.

Thank you for your time and consideration in responding to this application process. Your comments and observations are highly valuable and much appreciated! Again, thank you!

Karen Keller, Ph.D.
Creator of Keller Influence Indicator®

Leave this field blank

Main menu

User menu

Reference Form

Reference Form

Charter KII Partner Reference Form