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ARKANSAS STATE BOARD OF REGISTRATION FOR

PROFESSIONAL SOIL CLASSIFIERS

  675 Flat Rock Road

Booneville, AR  72927-8353

 

   

Applicant's Name____________________________________________________________________

 

The following information relative to the above named applicant is submitted at the applicant's f\request for the Board's use in considering his/her application for registration as a Professional Soil Classifier or Soil Classifier-in-Training with the understanding that it will be held in strict confidence.

 

1.             I have known the applicant for ________________________________ years.

 

2.                Relationship to applicant? _________________________________________________________

 

3.             The applicant is employed by ______________________________________________________

 

4.             The applicant's general reputation and character are_____________________________________

 

5.             My business connection with the applicant is __________________________________________

 

6.             I (would) (would not) employ the applicant in a position of trust because ____________________

 

                _______________________________________________________________________________

 

7.             I (do) (do not) believe that this applicant should be investigated further.

 

8.*           I believe the applicant's technical ability to be (poor) (average) (good).

 

9.*           I (would) (would not) employ the applicant on a project where his decisions would be final.

 

10.*         The following is my evaluation of the applicant's ability as a Professional Soil Classifier:

 

                _______________________________________________________________________________

 

                _______________________________________________________________________________

 

                _______________________________________________________________________________

 

My business or profession is _______________________________________________________________

 

I (am) (am not) a registered Professional Soil Classifier._________________________________________

 

I am associated with _____________________________________________________________________

 

My title is _____________________________________________________________________________

 

Date:________________________ Please type or print name: ____________________________________

 

Place: _______________________ Signature: ________________________________________________

 

*NOTE:  Character references or references for Soil Classifier-in-Training, please omit questions numbers 8, 9, and 10.