Reference form missionary

Applicants name

1. For how many years have you known the applicant?

2. Your relationship with the applicant:

3. Please summarize the applicant’s family background:

4. In reference to the applicant’s church service, do you consider the applicant to be?

Dedicated
Average
Casual

Would you like to make any comments?

summarize trust improvement?

Would you like to make any comments?

6. Is the applicant prejudiced against races and nationalities?

Yes
No

Would you like to make any comments?

7. As an employer, would you consider assigning a position of trust to the applicant?

Yes
No

Would you like to make any comments?

8. Would you recommend the applicant to be accepted by Globe Mission?

Yes
No

Would you like to make any comments?

9. Have you observed the applicant’s conduct with children? If no, proceed to question 10

Yes
No

Have you ever witnessed or heard of any misconduct towards children on the part of the applicant?

Yes
No

When working with children, what do you consider to be their biggest strengths and areas of improvement?

10. Please indicate

	Superior	Good	Average	Unsatisfactory
Initiative	SuperiorInitiative Superior	GoodInitiative Good	AverageInitiative Average	UnsatisfactoryInitiative Unsatisfactory
Social Adaptability	SuperiorSocial Adaptability Superior	GoodSocial Adaptability Good	AverageSocial Adaptability Average	UnsatisfactorySocial Adaptability Unsatisfactory
Concern for Others	SuperiorConcern for Others Superior	GoodConcern for Others Good	AverageConcern for Others Average	UnsatisfactoryConcern for Others Unsatisfactory
Ability to follow leadership	SuperiorAbility to follow leadership Superior	GoodAbility to follow leadership Good	AverageAbility to follow leadership Average	UnsatisfactoryAbility to follow leadership Unsatisfactory
Leadership Ability	SuperiorLeadership Ability Superior	GoodLeadership Ability Good	AverageLeadership Ability Average	UnsatisfactoryLeadership Ability Unsatisfactory
Personal Appearance	SuperiorPersonal Appearance Superior	GoodPersonal Appearance Good	AveragePersonal Appearance Average	UnsatisfactoryPersonal Appearance Unsatisfactory
Self-Discipline	SuperiorSelf-Discipline Superior	GoodSelf-Discipline Good	AverageSelf-Discipline Average	UnsatisfactorySelf-Discipline Unsatisfactory

Do you have any comments on the above topics?

First name, surname of the reference provider

Your address

Email address (only if you like to receive the completed form via email)