PERSONAL REFERENCE REQUEST FOR
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Your Name
*
Your Address
*
Relationship with candidate
*
Your Phone Number
-
Area Code
Phone Number
Your Email
example@example.com
2. Please Comment On The Following
How long have you known this individual?
In what capacity?
If yes, to the best of your knowledge, how long has this individual been a Christian?
Does the applicant appear to be growing in his/her relationship with the Lord? Please explain.
What is your impression of the applicant’s understanding of the Scriptures, ability to share the Gospel and prayer life?
How does the applicant conduct themselves with peers of the opposite sex?
Has the candidates honesty and integrity ever been brought into question that you are aware of? (Please comment)
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To the best of your understanding has the applicant ever been accused of inappropriate behavior with children?
In the following areas, please rate the applicant on the following scale. 1 to 5 (1=low and 5=high)
Ability to follow instructions:
1
2
3
4
5
How outgoing and friendly is he or she?
1
2
3
4
5
Ability to work in a team situation:
1
2
3
4
5
Positive attitude:
1
2
3
4
5
Cooperative:
1
2
3
4
5
Ability to lead others:
1
2
3
4
5
Enthusiastic:
1
2
3
4
5
Not inclined to criticize/ instead builds others up:
1
2
3
4
5
Able to work without close supervision/independent:
1
2
3
4
5
Trustworthy:
1
2
3
4
5
Flexible and able to adapt to changes in schedule and situation:
1
2
3
4
5
Disciplined in personal life and habits:
1
2
3
4
5
Not easily offended:
1
2
3
4
5
How consistently is he or she growing their testimony:
1
2
3
4
5
Not moody:
1
2
3
4
5
Ability to cope with others problems without adopting them as his or her own:
1
2
3
4
5
Please grade this individual in the following characteristics and traits.
Modest dress:
1
2
3
4
5
Public speaking:
1
2
3
4
5
Dependability:
1
2
3
4
5
Punctuality:
1
2
3
4
5
Initiative:
1
2
3
4
5
Attitude towards hard work:
1
2
3
4
5
Honesty and personal integrity:
1
2
3
4
5
Courtesy:
1
2
3
4
5
Communication:
1
2
3
4
5
Attitude toward authority:
1
2
3
4
5
Good at working with and relating to children:
1
2
3
4
5
Personal grooming and hygiene:
1
2
3
4
5
Sense of humor:
1
2
3
4
5
Tact: (ability to address hard subjects gently and appropriately)
1
2
3
4
5
Judgement:
1
2
3
4
5
Organization:
1
2
3
4
5
Ability to make friends:
1
2
3
4
5
Willingness to take and follow instruction:
1
2
3
4
5
Additional comments. If you would like to explain any of your ratings, please use this space.
There is a possibility that the applicant will be employed as a camp counselor or cabin leader. Would you consider the applicant qualified to direct and oversee your child or teenager? Please explain your thoughts.
Please give one strength and one weakness of the applicant: be as specific as needed.
I recommend this individual for his her position.
I strongly recommend
I recommend
I recommend with some reservation
I do not recommend
Please give any additional thoughts on the applicant's overall suitability to work in a youth ministry setting, such as Camp Witness.
I declare that to the best of my knowledge the information I have given in this reference is correct and complete
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I Agree
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