SpiL Trip Reference Form
This is a confidential reference and the information you provide will not be released to the applicant. Student application packets will not be considered "complete" until all 3 references have been received. Only students with complete applications will be considered for interviews.


The person identified above has applied to participate in a three week long George Fox University May Immersion and Service Trip in 2018 and has listed you as a reference. Students will be chosen for one of four international teams (Haiti, Kenya, Nepal, and Romania/Moldova) that will be led by university faculty/alumni/representatives and co-led by a student leader. Each SpiL team will be volunteering within the long-term ministry of well-established and respected Christian organizations.
Name of applicant filling out reference for *
Your answer
The personal characteristics indicated below are good indicators of how a student will respond in a challenging environment and in cross-cultural relationships. Please give us a frank assessment for each item including a numerical rating and any supporting comments. *
5 = Excellent
4 = Good
3 = Average
2 = Below Average
1 = Poor
n/a = insufficient basis for judgement
Maturity of Christian Commitment: Demonstrates a personal and growing faith in Jesus Christ
Flexibility and Adaptability: Ability to adjust plans on short notice. Willingness to adapt without complaint to practices which may not make sense in a North American context.
Emotional Stability: Ability to deal with the pressure of new circumstances. Ability to cope patiently with frustrated expectations and/or misunderstanding.
Openness and Initiative: Responds well in new experiences. Accepting of differences. Willingness to learn from those holding different viewpoints.
Team Player: Ability to follow, encourages and support the established leadership.
Responsibility: Consider the degree to which the applicant is dependable, prompt, accurate, and thorough.
Empathy and Interpersonal Skill: Sensitive to the perceptions and needs of others. Ability to befriend and relate well to new acquaintances. Cooperative attitude toward supervision.
If you were making selections for this program would you select this candidate? *
Additional comments?
Your answer
Name of Reference *
Your answer
Title and Relationship to Applicant *
Your answer
Address of Reference *
Your answer
Email of Reference *
Your answer
Phone of Reference *
Your answer
Electronic Signature *
Your answer
Any questions? Email mkadarmanto@georgefox.edu
Never submit passwords through Google Forms.
This form was created inside of George Fox University. Report Abuse - Terms of Service - Additional Terms