Pastor/Spiritual Leader Reference Questionnaire
Today's Date
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Month
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Day
Year
Date
Name of Candidate:
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First Name
Last Name
Name of Reference
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First Name
Last Name
Reference Email
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example@example.com
Reference Phone
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Best time to call?
Reference Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation of Reference
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The candidate named on the first page is applying to be a Hope Force Reservist and/or volunteer with our organization, and if accepted, will possibly be deployed into crisis scenarios, or areas of extreme, chronic need. Often, these scenarios are stressful, unpredictable and sometimes require extended work hours.
To help us in our assessment of the candidate, please compete the following evaluation, keeping in mind what activities that he/she might be involved in.
How long, how well and to what capacity do you know the Candidate?
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Character Trait Evaluation
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Rows
Not Known
Poor
Below Average
Average
Above Average
Exceptional
Comments
Ability to faithfully assume and carry out duties or obligations; work ethic
Personal appearance & manners
Punctuality
Ability to communicate & exchange thoughts with clarity & logic
Ability to lead or direct others
Ability to follow & listen to others
Ability to adjust in a healthy manner to changes in circumstances
Ability to interact with others from different cultural backgrounds
Ability to receive & apply constructive criticism; teach-ability
Self Discipline
Display of optimism
Quality of work
Integrity / Trustworthiness
Initiative
Ability to work well with a team
Sensitivity to the needs and feelings of others; tact
Reliability
General health; energy
Confrontation / Conflict resolution skills
Consistency of Christian life
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Please answer every question to the best of your ability. If you believe you are unqualified to answer a question, please type in N/A (not applicable) or N/O (not observed). If you would prefer that we call you regarding a particular question, please write, "Please phone.”
What are the candidate’s areas of professional strengths and abilities?
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How does the candidate adapt to new and/or stressful situations? (Please provide an example of observed situation)
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Has the candidate ever had any problems with teamwork, authority issues or anger outbursts that you have witnessed? If yes, please explain:
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Are there any other issues, problems or positive traits that have not been covered that you feel we should be made aware of?
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Are there any issues for which you would like us to call you so that you may give us an in-person explanation?
Thank you for your time and your feedback!
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