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Reference Form
What Type of Reference are you Giving?
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Friend/ Family
Pastor/ Spiritual Mentor
Educator/ Employer
Applicants Name
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Reference's Information
First Name
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Last Name
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Street Address
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Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Phone Number
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Email Address
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What is your relationship with the applicant?
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How long have you known the applicant
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How well do you know the applicant?
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Very Well
Well
Casually
Strengths and Weaknesses
Initiative
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Superior
Above Average
Average
Below Average
Social Adaptability
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Superior
Above Average
Average
Below Average
Concern for Others
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Superior
Above Average
Average
Below Average
Ability to Follow
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Superior
Above Average
Average
Below Average
Leadership
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Superior
Above Average
Average
Below Average
Judgement
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Superior
Above Average
Average
Below Average
Decision Making
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Superior
Above Average
Average
Below Average
Emotional Stability
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Superior
Above Average
Average
Below Average
Health
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Superior
Above Average
Average
Below Average
Personal Appearance
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Superior
Above Average
Average
Below Average
Mental Ability
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Superior
Above Average
Average
Below Average
Industry
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Superior
Above Average
Average
Below Average
Reliability
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Superior
Above Average
Average
Below Average
Cooperativeness
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Superior
Above Average
Average
Below Average
Flexibility
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Superior
Above Average
Average
Below Average
Christian Character
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Superior
Above Average
Average
Below Average
Disposition
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Superior
Above Average
Average
Below Average
Punctuality
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Superior
Above Average
Average
Below Average
Financial Responsibility
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Superior
Above Average
Average
Below Average
If you marked below average for any of the above please explain.
Any additional comments.
In what capacity is the applicant active in church work?
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Does he/she display high moral standards? (Please explain)
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Is he/she prejudiced against any groups, races or nationalities? (If yes please explain)
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With reference to his/her Christian service would you consider the applicant to be dedicated, average or casual? (Please explain)
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Please comment on the applicant’s Christian experience.
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Please comment on the applicant’s family background. (if known)
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What could YWAM do to aid in the applicant's personal development?
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Please add any other pertinent remarks: (medical, psychological, drug or alcohol abuse, criminal record or occult practices, etc.)
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Would you recommend the applicant for acceptance to a staff position with Youth With A Mission?
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Yes
Yes.. with reservation
No
If Yes, with reservation or No please explain.
I have answered all of the above questions to the best of my knowledge and experience with the applicant.
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