Intern Reference Form
Thank you for taking a moment to complete this reference form. We value your feedback as we build our Summer Intern Team!
Name of GO TELL Intern Applicant
*
First Name
Last Name
Your Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please provide the best number for our team to reach you.
Format: (000) 000-0000.
Email
example@example.com
In what capacity do you know the applicant?
*
Please Select
Pastor
Youth Pastor/Leader
Teacher
Coach
Family Friend
Employer
Other
How long have you known the applicant?
*
Please Select
Less than a year
1-5 years
More than 5 years
How well do you know the applicant?
*
Please Select
1 - Minimal
2
3
4
5
6
7
8
9
10 - Very Well
What level of communication have you had with the applicant in the last year?
*
Please Select
Minimal
Some
Significant
Very Personal
Please list at least three POSITIVE traits/adjectives that describe the applicant and explain how those traits might help their effectiveness while working for GO TELL:
*
Please list any NEGATIVE traits/adjectives that describe the applicant and explain how those traits might hinder their effectiveness while working for GO TELL:
*
Back
Next
Peer Relationships:
*
Please Select
Very Popular
Makes Friends Easily
Slow to Make Friends
Generally Avoids Making Friends
Family Relationships:
*
Please Select
Healthy & Supportive
Healthy, but not Supportive
Dysfunctional, but Supportive
Dysfunctional & not Supportive
Relationships with the Opposite Sex:
*
Please Select
Relates Well
Feels at Ease
Sensitive/Considerate but awkward
Insecure
Insensitive
Social Relationships:
*
Please Select
Socially Adept
Well-Mannered
Average
Awkward in Social Relationship
Avoids Social Relationships
Interpersonal Relationships:
*
Please Select
Overbearing
Outgoing/Friendly
Average
Reserved
Loner
Response to Stress/Pressure:
*
Please Select
Copes Well
Adapts Slowly
Dominates Situation or People
Becomes Overly Critical of Others
Withdraws Socially or Emotionally
Self-Assurance:
*
Please Select
Confident
Average
Needs Improvement
Insecure
Level of Spiritual Maturity:
*
Please Select
Mature & Consistent
Maturing Christian; Fairly Consistent
Growing; Showing Signs of Maturity
Up and Down; Inconsistent Spiritual Experience
Demonstrates Spiritual Immaturity
Ability to Work with Supervisors:
*
Please Select
Independent Worker; Able to Take Directions & Go
Cooperative in Most Situations
Rebellious Spirit; Likes to Do Their Own Thing
Ability to Work with Peers/Team Members:
*
Please Select
Works Well with Others
Has Average ability to Work with Others
Sometimes Has Difficulty Interacting
Has Problems Working with Others
Supervision Needs:
*
Please Select
Needs Little Close Supervision; Only Needs Direction
Does Well with Regular, Routine Supervision
Needs Accountability and Encouragement to Accomplish Tasks
Needs Excessive Supervision
Ministry Ability:
*
Please Select
Could Minister to Students One-on-One
Could Minister to Students with a Team
Could Serve in Either Setting
Should Not Minister to Students
On a team of 20-30 peers, this person would MOST LIKELY be:
*
The Leader
A Supportive Team Member
A Low-Initiative Follower
On a team of 20-30 peers, this person would LEAST LIKELY be:
*
The Leader
A Supportive Team Member
A Low-Initiative Follower
Please provide any additional information below which you think may be helpful to us as we consider this applicant
I declare that to the best of my knowledge the information I have given in this reference is correct and complete
I Agree
Signature
Send Form
Should be Empty: