Internship and Residency Personal References
This is intended for an applicant's pastor/spiritual leader, supervisor, teacher, mentor, or other significant adult (non
family; this should be someone who has seen the applicant in a variety of settings).

An applicant may not be accepted if we have not received their two personal references in a timely manner.

If you have questions, contact Paul Granger at Paul.Granger@CHATRichmond.org

Name of Applicant being considered for an Internship *
Your answer
Your Name *
Your answer
Role in Applicant's Life *
Your answer
Email Address *
Your answer
Preferred Phone Number *
Your answer
Please answer the following questions to the best of your knowledge, providing any relevant details.
Please describe the length and nature of your relationship with the applicant. *
Your answer
CHAT will provide an opportunity to live and work as an urban missionary in an urban community. What is it about the applicant's personality and experience that you think does or does not prepare him/her emotionally and spiritually to work with this kind of ministry? *
Your answer
What gifts for ministry have you perceived in the applicant? *
Your answer
What areas of weakness or need for growth do you perceive in the applicant? *
Your answer
Please describe the applicant's character in these areas:
Teachability *
Your answer
Flexibility *
Your answer
Servanthood *
Your answer
Response to Authority *
Your answer
Partnership on a Team *
Your answer
Do you have any reservations about recommending this applicant for this type of ministry? If so, please explain. *
(This could include the following areas; ability to engage in rigorous activity, self-control, substance abuse, chronic health problems, emotional or mental problems, etc)
Your answer
Interns are asked to raise financial support prior to, and during, their internship; do you foresee fundraising being a challenge for the applicant? *
Your answer
Would you like to make any other comments?
Your answer
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