This reference form must be completed by a person who is not an immediate family member of the applicant.

The information submitted in this form is very important to us and will be kept private for internal use only by Elijah House staff. If you have any questions, please feel free to call us at 1-800-788-2131 ext 201.

For Facilitated Schools, please download and complete this form, then turn in to the facilitator conducting the school or the student making the request.

 

For Live Schools, complete the following form and submit.