POLAND - RBTC Personal Reference

REFERENCE INFORMATION

Pastoral / Personal Reference Form
To those requested to submit a reference for an RBTC applicant:

Thank you for taking time to fill our this form on behalf of one of our applicants. We prayerfully consider each applicant for admission and your honest and candid evaluation is valuable in the RBTC admission process.

We will hold your comments in strictest confidence.
Your Name*

TitleFirst Name Last Name
Your Email Address*
example@example.com
Mobile Phone*

Country Code eg: 🇳🇴: +47 Phone Number eg: 123 456 789
RBTC Applicant for whom you are providing this reference?*

PrefixFirst NameLast Name
How long have you known the applicant?*
Describe your relationship with the applicant:*

Very CloseCloseCasualDistant
What is the nature of your acquaintance?

You are their...
Church*

PastorYouth/Children's PastorAssociate PastorSmall Group LeaderOtherNone of the above
Business*

EmployerSupervisorCo-workerSubordinateOtherNone of the above
Social*

Friend of the familyPersonal friendNeighborOtherNone of the above
School*

Principal / DeanTeacherFellow studentNone of the aboveSchool Counselor

Please evaluate his/her character by marking one of the following boxes:*

	Excellent	Good	Fair	Poor	Unknown
Honesty
Dependability
Cooperativeness
Ability to work with others
Moral character
Personal appearance
Consideration for others
Acceptance of instruction
Acceptance of discipline

How industrious is he/she as a student worker?*

Usually conscientious, hard workerWorks harder than most students/workersDoes about as much work as othersWorks less than most othersVery lazyHave no basis for judgement
Is the applicant prompt in paying his/her bills?

YesNoUnknown
Comments
From personal knowledge of the individual, would you?*

Highly recommend him/her as a candidate for training at RBTC.Recommend him/her as a candidate for training at RBTC.Recommend him/her as a candidate for training at RBTC with slight reservations.Hesitate in recommending him/her as a candidate for training at RBTC.I cannot recommend him/her as a candidate for training at RBTC.
Please explain your answer.*
Emotional Evaluation*

Very StableStableUnstableVery Unstable
Does the applicant respond well to authority?*

YesNoUnknown
What is the applicant's spiritual influence on others?*

PositiveNeutralNegative
Does the applicant associate with people of moral character?

YesNoUnknown
Does the applicant have a good home life and/or marriage?

YesNoUnknown
What do you consider to be the applicant's strong points?*
What do you consider to be the applicant's weak points?*
Is there any other information about the applicant that would help with our evaluation?*
I understand that the information contained in this reference will be kept as part of the student’s permanent file, and might be shared with RBTC affiliates to include RHEMA USA and RHEMA Europe. I consent to this and affix my signature.*

Clear
* I consent to the processing of my personal data by RHEMA Poland, ul. Bohaterów Getta Warszawskiego numer 7-9, 81-609 Gdynia (hereinafter: "Administrator"), for the purpose of using the contact form at www.rhema.org.pl . Provision of data is voluntary. The basis for data processing is my consent. Recipients of the data may be the Administrator. I have the right to withdraw my consent at any time. Personal data will be processed for the period necessary to respond or to revoke consent, and after such revocation, for the period of the statute of limitations for claims to and against the Administrator. I have the right to request from the Administrator access to my personal data, rectification, erasure or restriction of processing, as well as the right to lodge a complaint with a supervisory authority.
Thank you for your time and participation! If you have questions regarding this reference, please email us at biuro@rhema.org.pl
Should be Empty:

REFERENCE INFORMATION

What is the nature of your acquaintance?