Confidential Reference / Referencia confidencial

YWAM BLUEFIELDS - Confidential Reference Form

*Your submission is confidential and will not be shared with the student. Please be as honest as possible to help with our discipleship process of the applicant.
Name of Applicant*

First NameMiddle NameLast Name
PastorEmployerLeaderFriendOther
How well do you know the applicant?*
How long have you known him/her?*

Type a question*

Rows	Strong	Mature	Average	Developing	Weak
Leadership
Christian Character
Postive Sprit
Ability to motivate others
Ability to receive correction
Self-Confidence
Willing to serve
Emotional Stability
Ability to Communicate
Intellectual Ability
Financial Responsibility
Maturity
Integrity
Trustworthiness
Teachable
Assurance of Calling

Any Additional Comments?
To what extent is the applicant active in church/ministry/work? *
Is the applicant prejudiced against any groups, races, or nationalities? *
Does the applicant display high moral standards? *
MatureContagiousGenuine & GrowingOver EmotionalCasual
Overall what would you consider to be the applicant’s strong points?(Please include any special abilities that you may be aware of) *
What do you see as one of the applicant’s weak points? *
Is the applicant, to your knowledge, aware of their weak points and are they striving to improve in this area? *
Please comment on the applicant’s family background *
Does the applicant, to your knowledge, struggle in relation to any of the following areas: medical, emotional, psychological, smoking, drugs, alcohol? (Feel free to also comment on any other areas you feel we should know about) *
In your opinion, what are the applicant’s motives for applying to YWAM?*
ImpatientIntolerantArgumentativeDominantArrogantCriticalShyEasily OffendedFrequently DiscouragedFrequently WorriedNervousAnxiousIrresponsibleBad HumorWithdraws to selfPrejudicedGossipCauses fights (or friction)InfatuatedImpulsiveWithout HumorDishonestLazyPassiveIndifferentUnstable
To your knowledge, has the applicant ever been arrested for any public offense? *
Please explain the arrest*
YOUR PERSONAL INFORMATION
Name*

First NameLast Name
Are you a pastor?*
Is your congregation standing behind the applicant with enthusiasm and prayer?*
What is your opinion about the applicant’s desire to participate in a DTS?*
Address

Street Address

Street Address Line 2

CityState / Province/Department

Country
Phone Number*
Signature

Limpiar
Thank you for your time in filling out this reference form. If you would like more information about DTS, YWAM BLUEFIELDS or YWAM International, please contact us via email at reneymigi@ywamnicaragua.org. Or visit us on our website: www.ywambluefields.org or www.ywam.org
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YWAM BLUEFIELDS - Confidential Reference Form

YOUR PERSONAL INFORMATION