Reference Form

We appreciate your willingness to help us understand this applicant and his/her strengths and weaknesses. It will benefit the applicant and CIY if you are completely open and unreserved with your responses.

Applicant name

Your Name

Your Phone Number

How long have you known this person?

In what capacity have you know this person?

In your opinion, what are the major strengths of this person?

What areas of weakness or need for growth do you perceive in the applicant? Be specific.

Please comment on opportunities you have had to observe this person exercising their gifts and talents in the areas of teaching, preaching, music, drama, etc.

To what extent would you consider him/her grounded in his/her Christian beliefs and knowledge of the Bible? How has this been demonstrated? Be specific.

How does the applicant’s mental and emotional maturity correlate with his/her biological age?

What do you believe is the applicant’s primary motivation for wanting to go on this trip?

Please evaluate the applicant in the following character/personality traits:

Personal Characteristics

Please evaluate the applicant in the following character/personality traits.

Key: 1=Poor,2=Fair,3=Average,4=Above Average,5=Excellent

	1	2	3	4	5
Honesty and transparency
Self-image
Personal Appearance/Hygiene
Considerate of Others
Flexibility
Servant’s Heart
Physical Capabilities
Dependable
Spiritually Disciplined
Submissive to Authorities
Heart for Evangelism
Moral Standards
Overall Emotional Maturity

Please comment on anything else you feel we should know regarding the applicant, including things from the past that you feel might negatively affect him/her now.

If you were in our position, seeking the kind of servant we’re seeking, would you accept this applicant?