Full Name* First Name Last Name Email* Phone Number*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands 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* Pastor Youth Pastor Employer Friend Co-Worker Mother Father Brother Sister Aunt Uncle Rate each of the following:1 (poor) - 5 (excellent) or U (unknown) Note: These are not judgment statements, but ratings based on your observations and interactions with the applicant.Ability to disciple and mentor others* 1 2 3 4 5 U Administration and organization* 1 2 3 4 5 U Christian witness in the community* 1 2 3 4 5 U Conduct with the opposite sex* 1 2 3 4 5 U Conflict resolution* 1 2 3 4 5 U Dependability* 1 2 3 4 5 U Emotional stability* 1 2 3 4 5 U Evidence of the fruit of the Spirit* 1 2 3 4 5 U Freedom from sin and addictions* 1 2 3 4 5 U Home environment* 1 2 3 4 5 U Industriousness and work ethic* 1 2 3 4 5 U Leadership skills* 1 2 3 4 5 U Mercy for the hurting and needy* 1 2 3 4 5 U Relating to people from other cultures* 1 2 3 4 5 U Sensitivity to others* 1 2 3 4 5 U Social and relational skills* 1 2 3 4 5 U Willingness to serve* 1 2 3 4 5 U Comments*Applicant's effect on community* Builds Loves and lives within it Drains energy from Damages or destroys Applicant's relationship to authority* Appreciative of input and guidance Quiet submission Begrudging obedience Resentful or rebellious Describe one area in which you have seen growth in the personal character of the applicant over the last year.*Rate each of the following:1 (not a problem) - 5 (serious concern) or U (unknown) Note: These are not judgment statements, but ratings based on your observations and interactions with the applicant.Careless* 1 2 3 4 5 U Critical* 1 2 3 4 5 U Depressed* 1 2 3 4 5 U Divisive* 1 2 3 4 5 U Easily embarrassed* 1 2 3 4 5 U Easily offended* 1 2 3 4 5 U Immature* 1 2 3 4 5 U Impatient* 1 2 3 4 5 U Impulsive* 1 2 3 4 5 U Intolerant* 1 2 3 4 5 U Moody* 1 2 3 4 5 U Prejudiced* 1 2 3 4 5 U Proud* 1 2 3 4 5 U Selfish* 1 2 3 4 5 U Worried* 1 2 3 4 5 U Comments*Relates best with (multiple answers are fine):* Children Teens Adults Not sure Other (explain in comments) Applicant's interest in missions*Short-termLong-termNot sureHas the applicant been involved in abusive relationships, as a victim or an abuser?*NoYesUnknownHow likely would you be to hire the applicant to serve with your mission or or organization? (1 being unlikely, 5 being very likely)* 1 2 3 4 5 Best time/days to call (if necessary)* CommentsDo you know others who might have interest in the Ministry Training Center? If so, please list their names and contact information below.After you click "Submit" you will receive an email confirmation and be redirected to our web page about the Serve NYC Internship.HiddenIntern or LTO Reference (Hidden Field)