Provide character reference Quick and Simple)

I need 1 person to provide a "faux" character reference for me. I have already received 12 other references from friends and employers and I am completely out of ideas of whom else could provide me one, but I need just 1 more. There are a total of 5 questions that need to be answered. Also, there are 20 short descriptive words that must be circled. I have attached a sample of the 2nd page so that you can see. You will need to have access to a printer in order to print the forms out and upload them to the computer. You must be in the U.S. and have a U.S. cell phone number or office phone because someone may call you to verify, but more than likely they will not. They may just email you instead. You must email the forms to the email address provided on the first page (I will provide the first page after I award you) and BCC me. (BCC means "blind carbon copy" me in case you do not understand) Helps if you have given references to people before and understand how to write well. This will take 7 minutes or less, so please place a REASONABLE bid. I will award within 24-48 hours. Thank You!!