Pastor/ Pastoral Staff Confidencial Reference Form
To the person filling out this form: The below named person as applied for participation in YOUTH WITH A MISSION. In view of the work in which the applicant will be involved, we wold greatly appreciate your careful and thoughtful consideration to the questions asked on this form. All Evaluation forms will be kept in Strict confidence and will not be shown to the applicant.
Name of Applicant *
First Name, Last Name
How long have you known the applicant? *
How well do you know the applicant? *
How long has the applicant attended your church? *
In your association with the applicant, what has been the level of commitment you have seen exemplified? *
Please rate according to what you have observed, the applicant's effectiveness in the following areas: *
Not Observed
Motivating & Training
Personal Evangelism
Working with Children
Working with Adults
Servant Hearted
Has the applicant participated in any of the above areas while under your leadership? *
Did you know prior to receiving this form of the applicant's intention to attend this program? *
Does the applicant know Jesus Christ as personal Lord and Savior? *
Do they show Christ in everyday living? *
Do you believe that the applicant has a call to missions from God at this time? If so, then please explain: *
Check any of the following, which you feel, are motivating the applicant to attend a YWAM school? *
If you checked other please explain here:
Please rate this applicant by placing a check under each of the following categories:
Physical Condition *
Personal Appearance *
Intelligence *
Teamwork *
Social Adapatability *
Emotional Resilience *
Industrious *
Reliability *
Flexibility *
Dispostion *
Punctuality *
Financial *
Listed below are some of the qualities, which describe a leader.
Please rate as follows: 1=Weak, 2=Developing, 3=Average, 4=Mature, 5=Strong
Positive, contagious spirit *
Decision Making Ability *
Ability to receive criticism *
Ability to motivate others *
Gets along with everyone *
Assurance of God's calling *
Self-confidence *
Teachable attitude *
Respect for the convictions of others *
Communicates Skills *
Emotional Stability *
Social Poise *
Able to deal with inter-personal problems *
Please elaborate if the answer is "YES" to any of the following questions:
a) Has the applicant proven on any occasion to be unreliable, dishonest or of questionable character?
b) As far as you know, has the applicant ever been arrested for any offense other than minor traffic violations?
c) To your knowledge, has the applicant ever been involved in drug abuse, the occult or homosexuality?
d) Does the applicant use tobacco or consume alcohol at this time?
If YES to any of the previous questions please explain here:
If the Answer is to all the above questions is "NO" please check here:
For discipleship purposes, would you please check words or descriptions which may pertain to the applicant:
(If you have noticed any of these, or similar limitations in the applicant's life, please elaborate below.)
Is your congregation standing behind the applicant's decision to attend this school? *
YES or NO please explain if NO.
Please comment briefly on the applicant's family background: *
Would you please make any comments regarding the applicant which you feel could be helpful:
Would you recommend the applicant for the YWAM School that he/she is applying for? *
Please feel free to make any other comments that you feel would benefit us as we prayerfully consider the above applicant.
I declare that the contents of this confidential reference are correct to the best of my knowledge.
I declare *
Name *
Address *
Day Phone *
Evening Phone/Cell phone *
Date *
By checking this box, I am signing this document and declare that I have filled out this form. *
I would like more information on YOUTH WITH A MISSION
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