Test Ref Response | Louisiana Board of Professional Geoscientists

Name Description Weighting Name of Respondent ReferenceID ApplicantID How long have you know the applicant personally? Applicant's Name How long have you known the applicant professionally? Reference's Address Job Title / Position Are you a degreed geoscientist? Yes No Relevant geoscience work experience What is/was your business or professional relationship to the applicant? Do you hold a license? Yes No List states, certificate, license or registion number and date. Describe applicant's moral and ethical character and personal reputation. If other, please describe Do you have knowledge of the applicant's participation in professional misconduct? Would you recommend this applicant for licensure/certification? Yes No Note