Referral and Reference Form

for Staff Positions at On The Go

Applicant: _______________________________________________________

The Applicant has chosen you as a reference and we would like you to give us your opinion regarding their fitness or ability to serve with our evangelistic mission ministry. This is confidential!

* What is your relationship to the applicant (check all that apply)

(  ) Pastor

(  ) Youth Pastor

(  ) Co-Worker

(  ) Relative

(  ) Good Friend

(  ) Casual Relationship

(  ) Very Little Contact

(  ) No Contact

* How long have you know the applicant? ______

* Why do you think the applicant wants to be a part of our ministry?

(  ) Supportive of all church activities

(  ) Because it is exciting and new

(  ) Called to Missions or Evangelism

(  ) Because everyone else is going

(  ) To have something to do

(  ) To escape reality

* Which of the following describe the applicant (In your opinion)

(  ) Dedicated to the local church

(  ) Fun to be around

(  ) Moody

(  ) Adventuresome

(  ) Dedicated

(  ) Rebellious

(  ) Follower

(  ) Leader

(  ) Christian

(  ) Church leader

(  ) Critical

(  ) Everyone admires

(  ) Adaptable

(  ) Dependable

(  ) Mature

(  ) Spiritual

(  ) Athletic

(  ) Argumentative

(  ) Into Dating Heavy, Romantic

(  ) Self Centered

(  ) Driven

* Comments relating to any of the items above: (Please detail on back or on separate sheet)

* Use this code for the following questions! Circle: G-Good, A-Average, P-Poor, N-No basis to answer.

1. What is the Mental condition of the Applicant? G A P N

2. How doe the Applicant relate to Authority? G A P N

3. How does the Applicant's Peers relate to Him/Her? G A P N

4. How would you rate the Applicant's Leadership ability? G A P N

* What part does the Applicant play at His/Her Local Church? ________________________________________

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* Does the Applicant have any Social/Moral habits that we should know about? ____________________________

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* Do you have any reservations about or lack confidence in the applicants ability to minister on an evangelistic outreach team/ministry? (please explain) __________________________________________________________

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* Please read the following and mark the answer that closest represents your recommendation level for this applicant.

(  ) Has my highest recommendation

(  ) Has my recommendation based on limited knowledge

(  ) I do not recommend the Applicant

(  ) I recommend with some reservations (explain on back)

Signature: __________________________ Name: _____________________________________

Phone: _____________________________ Address: ___________________________________