ADS Reference - Life group Leader or Spiritual Mentor

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Thank you for taking time to fill out this character reference form. The applicant that gave you this form has applied to be a student in the Antioch Discipleship School (ADS) beginning in September 2019. This reference is for information concerning the applicant's character and fitness for this school. The Training School staﬀ values your honest, straightforward answers, evaluating his/her strengths and weaknesses. Be assured that your reply will be held in strict confidence and that the applicant will not see this form after you complete it.

Reference Name *

Reference Phone Number *

Reference Email

Reference Occupation *

How long have you known the applicant? *

How well do you know the applicant *

Very Well

Well

Average

Not Very Well

Almost Not At All

Describe your relationship with the applicant *

Does the applicant have the ability to make decisions and follow through with them? If no, please explain. *

How does the applicant respond to authority? *

Can the applicant take responsibility and demonstrate leadership? Give examples: *

Is the applicant sensitive to the needs, feelings and attitudes of others. *

What is the applicant’s attitude toward other groups, races of nationalities? *

To your knowledge, how does the applicant respond under difficult circumstances? *

Is there any indication that the applicant's decision to do the discipleship school has been significantly influenced by: A desire to escape personal, family or vocational situations? Or an unrealistic expectation of the training school? If yes, please explain. *

Are you aware of any instance of mental or emotional illness or difficulty which the applicant has had? If yes, please explain. *

Do you have any reservations concerning the financial integrity and/or indebtedness of the applicant? If yes, please explain. *

Have you ever had reason to question the applicant’s morals? If yes, please explain. *

What are the applicant's strengths, talents, or spiritual gifts? *

What, in your opinion, are some areas of growth most needed by the applicant? *

Please assess the applicant in the following areas: *

Excellent

Above Average

Average

Below Average

Poor

Unknown

Self-discipline

Adaptability

Dependability

Punctuality

Social poise

Communication skills

Respected by peers

Spiritual maturity

Knowledge of the Bible

Fruitful witness for Christ

Integrity (Consistency of Christian Lifestyle)

Teachability

Perseverance in completing a task

Please assess the applicant's self-image. *

Which option best describes their overall tendency

Insecure

Inferiority complex

Self-confident

May be prone to boast

Modest, true estimate of self

Other:

Thank you for filling out this reference. We appreciate your time and honesty. How closely do you anticipate walking with them over this next year?

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