Retreat Leader Reference Form

*First Name
*Last Name
*Preferred Name
*Address 1
*City
*State
*Zip
*Phone
*Email
*What is your relationship with the potential retreat leader?
*What are his/her strengths as a program leader/speaker?
*Do you have any reservations about his/her leadership? If so, what are they?
Any other comments?

Thank you for your assistance.

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