Confidential reference form

Confidential Reference Form
Applicant should have one form completed by their pastor and one form completed by their friend.

If you have completed any YWAM training one form must be from your most recent YWAM leader.
Applicant name:*
Applying for:*

Discipleship Training SchoolSchool of Strategic MissionYWAM StaffShort Term Volunteer
The above named applicant is appying for admission to one of our schools or for a position as a staff member with Youth With A Mission, Bethlehem, South Africa. In order to adequatley evaluate the applicant, we would appreciate your supplying the information requested on this form. Your comments will help us to make a wise decision in accepting the applicant and to effectively meet his/her need should he/she be accepted into the program applied for.
How long have you known the applicant?*
In what capacity do you know the applicant?*

CHURCH (Pastor/Home Group Leader/Etc)BUSINESS (Employer/Supervisor/Co-Worker)YWAM (School Leader/Base Leader/Etc)SCHOOL (Principal/Teacher)SOCIAL (Family friend/Personal friend)
On a scale of 1-10, how well do you know the applicant? 1=very little, 10=intimately *
How long has the applicant attended your church? (If applicable)
In what ways has the applicant been involved in the church? (If applicable)
In your association with the applicant, what level of commitment have you seen exemplified?*

FaithfulInconsistantOther
If "other" please specify
Please describe in your own words how would you rate the applicant in the following areas:
Initiative*
Industriousness*
Social Adaptability *
Reliability *
Personal Appearance*
Cooperation*
Concern for others*
Self Discipline *
Leadership*
Christian Character*
Emotional Stability*
Temperament *
Ability to Follow*
Punctuality*
Flexibility *
Perseverance *
Stewardship*
Ability to cope with stress*
Which words or descriptions pertain to the applicant?*

ImpatientIntolerantArguementativeDomineeringCritical of othersEasily offendedDiscouragedFrequently worriedAnxiousPrejudice towards other races/nationalitiesUnable to cope with stressErratic in actions or attitudesNone of the above
If you have noticed any of the above, please elaborate
Has the applicant proven on any occasion to be unreliable, dishonest or of questionable character?*

YesNo
If yes, please explain
In your opinion, which of the following would best describe the applicants christian experience?*

MatureContagiousGenuineGrowingOver emotioalSuperficial
Please comment briefly on the applicants family background (if known)
Is the applicant financially responsible?*

YesNoUnaware
Comments
Does the applicant respond well to authority?*

YesNoUnaware
Comments
Is there anything regarding the applicant which you feel would be helpful for us to know?
Do you recommend the applicant?*

WholeheartedlyYes, but with reservationNot at all
Comments
I declare that the contents of this confidential reference form are correct to the best of my knowledge
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Country CodeArea CodePhone Number
Date*

MonthDayYear
Date
Should be Empty:

Confidential Reference Form