| Ministry Training Center

Full Name*

First Name Last Name

Email*

Phone Number*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Applicant you are referencing*

First Name Last Name

Email address of the applicant (make sure that this is correct)*

Your relationship to the applicant*

Rate each of the following

1 (poor) - 5 (excellent) or Unknown. Note: These are not judgment statements, but ratings based on your observations and interactions with the applicant.

Ability to disciple and mentor others*

Administration and organization*

Christian witness in the community*

Conduct with the opposite sex*

Conflict resolution*

Dependability*

Emotional stability*

Evidence of the fruit of the Spirit*

Freedom from sin and addictions*

Home environment*

Industriousness and work ethic*

Leadership skills*

Mercy for the hurting and needy*

Relating to people from other cultures*

Sensitivity to others*

Social and relational skills*

Willingness to serve*

Comments*

Applicant's effect on community*

Applicant's relationship to authority*

Rate each of the following

1 (not a problem) - 5 (serious concern) or Unknown. Note: These are not judgment statements, but ratings based on your observations and interactions with the applicant.

Careless*

Critical*

Depressed*

Divisive*

Easily embarrassed*

Easily offended*

Immature*

Impatient*

Impulsive*

Intolerant*

Moody*

Prejudiced*

Proud*

Selfish*

Worried*

Comments*

Has the applicant been involved in abusive relationships, as a victim or an abuser?*

How does the applicant relate with children?*

How comfortable would you be with the applicant taking care of your children for 6 weeks?*

Best time/days to call (if necessary).*

Comments

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After you click "Submit" you will receive an email confirmation and be redirected to our web page about the Long-Term Orientation.