Reference Form - Georgia Department Of Human Services Youth Empowerment Series
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About
The Georgia Department of Human Services Youth Empowerment Series (DHS YES) is an
outreach program which seeks to develop a generation of young people who are engaged in
the needs of their communities and equipped to educate and recruit others to help DHS
build Stronger Families for a Stronger Georgia. For more information about YES, please visit
dhs.georgia.gov/youth-empowerment-series-yes
Each YES applicant is required to submit two reference forms in order to be considered for
participation in the program. Please complete and submit this form on behalf of the student
applicant.
Name of Student Applicant
Name of Reference
Phone Number
E-mail
Position/Title
Company
Address
Signature
Date
Length of time you have known the applicant:
Capacity in which you have known the
applicant:
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