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Sensible Nutrition And body image Choices

SNAC Recommendation Form


___________________________________, a candidate for a S.N.A.C. peer educator position has included you as a reference on his/her application.

Please complete and return this reference to Health Promotion, Room 268, Lafene Health Center by October 1st. PLEASE DO NOT RETURN THIS CONFIDENTIAL REFERENCE FORM TO THE CANDIDATE.

Please rate the applicant based on the rating scale below

O - outstanding, MS - more than satisfactory, SAT – satisfactory,
NI – needs improvement, U – unsatisfactory, NO – not observed

Ability to serve as a role model      
Time Management skills      
Balances academics vs. responsibilities      
Objectivity skills      

How long have you known the candidate?    _______Years   _______ Months

How do you know the candidate?

How well do you feel you know the candidate?

______ Only casually   ______ Moderately well   ______ Very well

Reference Name:___________________________________  Date:__________________
(Attach business card if you know this candidate as an advisor, instructor, or employer.)

May we contact you for further questions? _______________  Phone_________________

Please complete the following information.

Strengths and Limitations

Please identify one major strength and one limitation for this candidate.



You may use an extra sheet, if necessary, to write additional comments.

Thank you for your assistance!

This completed reference form should be returned by October 1st.  
(If you have questions, call 785.532.6595 or send an email to

For information about the mission of the SNAC Peer Educators as well as criteria used for selection of volunteers, please refer to the SNAC website at  If you have additional questions please call 785.532.5240.

Dianna Schalles, MS, RD, LD
SNAC Advisor
Health Promotion/Nutrition Counseling
Lafene Health Center
1105 Sunset Avenue
Manhattan, KS 66502-3761
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