Pastoral-Personal-Reference - Global Mission Awareness

Skip to content

Pastoral / Personal Reference

Dear Referee of Ministry Trip Applicant, You have been nominated by the applicant to complete this confidential reference to ascertain the suitability of the applicant for a Global Mission Awareness Ministry Trip. We take seriously our responsibility toward those to whom we minister, both here and abroad. Therefore, Global Mission Awareness greatly appreciates your supplying the information requested on this form. This form must not be completed by a family member or relative of the applicant. References will be checked to ascertain the integrity of the reference.
Trip Destination: (required)*
Applicant's Name: (required)*
Referees Full Name: (required)*
Referees Email: (required)*
Referees Phone: (required)*
How long have you been acquainted with the applicant? (required)*
What is your relationship to the applicant? (required)*
The applicant must be able to accommodate himself/herself readily to unaccustomed living conditions and new social situations. Adjustment may have to be made in relation to diet, social customs, climate changes, etc. Keeping in mind the challenge of these unusual demands, please rate this applicant by checking a block under each of the following categories.
Physical Condition:
- Below average health
- Average health
- Good health
- Excellent health
Social Interaction:
- Avoided by others
- Tolerated by others
- Liked by others
- Well-liked by others
Emotional Resilience (in trying situations):
- Gets angry; impulsive
- Withdrawn
- Easily discouraged
- Calm & resilient
Achievement (ability to formulate, execute & carry plans to conclusion):
- Starts but does not finish
- Does only what is assigned
- Meets average expectations
- Superior creative ability
Teamwork:
- Frequently causes friction
- Insists on having own way
- Usually cooperative
- Works well with others
- Energized by teamwork
Willingness to serve:
- Reluctant
- Motives confused
- Usually willing
- Eager
Leadership (ability to inspire others & maintain their confidence):
- Low leadership ability
- Tries but lacks ability
- Some leadership ability
- Competent leader
Prayer Ministry (experience praying for inner and physical healing)::
- Very little experience
- Moderate experience
- Experienced minister
- Highly experienced
Christian experience:
- Relatively superficial
- Over-emotional
- Alert and good mind
- Brilliant, exceptional
Responsiveness (to feelings & needs of others):
- Low sensitivity
- Reasonably responsive
- Understanding/thoughtful
- Extremely responsive
Listed below are some of the tendencies which, if present, may reduce the effectiveness of the applicant. Please tick any words or descriptions which pertain to applicant (leave blank if none apply)
- Impatient
- Argumentative
- Domineering
- Cocky
- Easily Offended
- Critical of others
- Anxious
- Easily embarrassed
- Easily discouraged
- Frequently worried
- Nervous or tense
- Given to moods
- Intolerant
- Lacking in humor
- Can't take a joke
- Unable to cope with stress
- Erratic in attitudes
- Racially prejudiced
- Self-absorbed
Please comment briefly on the family and social background of the applicant (if known)
Is the applicant financially responsible?*
- Yes
- No
Please describe any physical limitations the applicant may have.
To the best of your knowledge, has the applicant:
Proven on any occasion to be unreliable, dishonest, or of questionable character?*
- Yes
- No
Ever been arrested for any offense other than minor traffic violations?*
- Yes
- No
Ever been involved in drug abuse, homosexuality, or the occult?*
- Yes
- No
Ever received psychiatric treatment?*
- Yes
- No
Any unresolved problems in their life? (eg. anger, unforgiveness, impurity)*
- Yes
- No
If your responded YES to any of the above please briefly outline details:
What is your overall evaluation of the applicants promise as a Ministry Team applicant?
- He/she is definitely unsuited
- At this time I feel he/she is not suited
- He/she is a good prospect, but I have reservations
- He/she is an average prospect
- He/she is an above average prospect
- He/she is an exceptional prospect
Check any of the following that you feel are motivating the applicant to become involved with ministry team:*
- Christian Service
- Desire to spread the gospel
- Receive help, ministry
- Travel
- Desire to help others
- Escape unpleasant home situation
- Adventure
- Discipleship
- Other
Electronic Signature (full name required):*
First Last
Date
MM slash DD slash YYYY