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)

In which area(s) of church life has the applicant served, and in which area(s) is he/she currently serving? (required)


Evaluation of Applicant’s Emotional & Spiritual Maturity:

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

(In trying situations) Gets angry; impulsive Withdrawn Easily discouraged Calm & resilient

(Ability to formulate, execute & carry plans to conclusion) Starts but does not finish Does only what is assigned Meets avg 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

(Ability to inspire others & maintain their confidence) Low leadership ability Tries but lacks ability Some leadership ability Competent leader

(Experience praying for inner and physical healing)  Very little experience Moderate experience Experienced minister Highly experienced

CHRISTIAN EXPERIENCE: Relatively superficial Over-emotional Genuine but mild Rich and growing

INTELLIGENCE: Slow learner Sound intelligence Alert and good mind Brilliant, exceptional

(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)

Date: (required)