Reference Form

Reference Form
Applicant's Name (not your name) who has requested this reference:*

First NameLast Name
Program or position applicant is applying for (if known):*

DTS (Discipleship Training School)VolunteerYWAM Starkville Staff
YOUR Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Relationship to Applicant:*
How long have you known the applicant?*

On a scale of 1-5, how well do you feel you known the applicant?*

	1	2	3	4	5

1 is Very Little, 5 is Intimately

Your Church Name (if applicable):*
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Website:
example@example.com
What do you consider to be the applicant's strengths?*
Leadership, Teamwork & Problem Solving

A YWAM missionary must be able to accomodate to unaccustomed living conditions and new social situations. Adjustments may have to be made as to diet, social customs, climate changes, etc. Keeping in mind the challenge of these unusual demands, please anser the following questions
Flexibility:*

InflexibleAverageOpen to changeNot observed
Achievement (ability to formulate, execute and complete plans):*

Starts but doesn't finishDoes only what's askedMeets average expectationsSuperior creative abilityNot observed
Is the applicant usually punctual?*

YesNoNot observed
Reliability:*

Neglects obligationsAverageMeets obligationsNot observed
Teamwork:*

Often causes frictionUsually cooperativeWorks well with othersNot observed
Can he/she lead and organize others?*

YesNoNot observed
Leadership (ability to inspire others and maintain their confidence):*

Makes no effort to leadTried but lacks abilityHas leadership promiseUnusual ability to leadNot observed

Listed below are some of the qualities which describe a leader. Please rate the Applicant in:*

	Strong	Mature	Average	Developing	Weak	Not Observed
Positive attitude
Respect for others' opinions
Teachable attitude
Ability to make decisions clearly
Ability to deal with interpersonal problems
Self-confidence
Ability to communicate clearly
Ability to receive criticism
Social poise

How do you think the Applicant will respond to living in community with people from different cultures, age groups, church denominations, etc? What will be his or her greatest strength and challenge in this living environment?*
Can he/she solve problems creatively?*
Temperament
In your opinion the applicant is (check all that apply):*

ShyThoughtfulSternOutgoingHelpfulIndependentEncouragesFlexibleIndustriousDiligentNeglectsEnjoys responsiblityOverly sensitiveStubbornSloppyFearfulQuietLovingBoldFriendlyReservedFollowsBossyConsiderateInflexibleReliableForgetsCarelessLazyNervousDramaticMoodyClumsy
How does he/she take constructive criticism?*

Feels hurtRebelsAccepts with thanksRejects, but learnsNot observed
Willingness to serve:*

Reluctant to serveMotives confusedEager to serve as neededNot observed
Responsiveness to the feelings and needs of others:*

Slow to sense how others feelReasonably responsiveUnderstanding and thoughtfulUnusually responsiveNot observed
Listed below are some of the tendencies, which if present, may reduce the effectiveness of a YWAM missionary. Please select words or descriptions that pertain to the Applicant:*

ImpatientArgumentativeCritical of othersEasily offendedFrequently worriedFrequently nervous or tensePrejudiced towards group, races or nationalitiesUnable to cope with stressIntolerantDomineeringEasily embarrassedEasily discouragedFrequently anxiousGiven to moodiness or mood swingsLacking in humor, or inability to take a jokeErratic in attitudes or actionsThe Applicant seems relatively free from all such tendenciesNot observed
If you have noted any of these or similar limitations in the Applicant's life, please elaborate:
Other
Is he/she actively involved in a church?*

YesNoNot sure
Physical Condition:*

Frequently incapacitatedFairly healthy/AverageGood healthUnsure/Not observed
Financial Responsibility:*

NeglectfulAverageHonors obligationsNot observed
Please comment on your choices:
Check any of the following which you feel are motivating the Applicant to become part of YWAM:*

Christian serviceEscape an unpleasant home situationReceive help, ministry, and discipleshipDesire to spread the GospelDesire to help othersTravelAdventureOtherUnknown
Please comment on the Applicant's family background:*
Please choose any that apply, to the best of your knowledge*

The Applicant has proven on occasion to be unreliable, dishonest, or of questionable characterThe Applicant has been arrested for any offense other than minor traffic violationsThe Applicant has been involved in drug/alcohol abuseNone ApplyUnknown/Unobserved
If one or more were chosen above, please explain:
What is your overall evaluation of the Applicant's promise as a YWAM worker?*

Definitely unsuitedAt this time, I feel the Applicant is not suitedA good prospect, but I do have some reservationsAn average prospectAn above-average prospectAn unusually exceptional prospect
If you have reservations about their suitability, please elaborate:
What is your recommendation for the Applicant?*

To be acceptedNot to be accepted
Is your recommendation:*

StrongHesitantWeak
Do you have any further comments or requests?
Should be Empty: