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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)
Cuba May 2023
Cuba September 2023
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.
Below average health
Avoided by others
Tolerated by others
Liked by others
Well-liked by others
Emotional Resilience (in trying situations):
Gets angry; impulsive
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
Frequently causes friction
Insists on having own way
Works well with others
Energized by teamwork
Willingness to serve:
Leadership (ability to inspire others & maintain their confidence):
Low leadership ability
Tries but lacks ability
Some leadership ability
Prayer Ministry (experience praying for inner and physical healing)::
Very little experience
Alert and good mind
Responsiveness (to feelings & needs of others):
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)
Critical of others
Nervous or tense
Given to moods
Lacking in humor
Can't take a joke
Unable to cope with stress
Erratic in attitudes
Please comment briefly on the family and social background of the applicant (if known)
Is the applicant financially responsible?
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?
Ever been arrested for any offense other than minor traffic violations?
Ever been involved in drug abuse, homosexuality, or the occult?
Ever received psychiatric treatment?
Any unresolved problems in their life? (eg. anger, unforgiveness, impurity)
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:
Desire to spread the gospel
Receive help, ministry
Desire to help others
Escape unpleasant home situation
Electronic Signature (full name required):
MM slash DD slash YYYY