Reference Form | SIM Canada

Name of Applicant*

First Last

Name of Person Providing Reference*

First Last

Address of Person Providing Reference*

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

Phone*

Please evaluate the applicant as fairly as you are able by marking your ratings on the following continuums. If you don't feel qualified to give an answer in a particular area, please mark it as Don't Know. Your responses will be kept confidential.

SPIRITUAL

Salvation*

Evaluate the applicant's demonstration of being born again. (0-little evidence, 10-strong evidence)

Relationship with Christ*

Evaluate daily practice of his/her faith (0-inconsistent, 10-consistent)

Church Involvement*

Evaluate relationship with local church (0-uninvolved, 10-deeply involved)

Trust in God*

Is the applicant anxious or trusting? (0-constantly anxious, 10-consistently trusting God)

Ministry Skills*

Is the applicant capably involved in ministry? (0-uninvolved, 10-capably involved)

Knowledge of Scripture*

(0-very limited, 10-exceptional)

Concern for and Witness to the Lost*

(0-unconcerned, 10-actively witnessing)

Comments on any of the above

PERSONAL

Work Habits*

(0-sloppy/unreliable, 10-reliable/precise)

Initiative*

Does the applicant take the initiative in most situations? (0-always waits for others, 10-self starter)

Relationship to Authority*

How does the applicant respond to authority? (0-rebellious, 10-respectful)

Cooperation*

Does the applicant function well as a part of a team? (0-difficulty with teams, 10-consistent team player)

Social Acceptance*

How does the applicant's personality affect others? (0-tolerated, 10-sought after)

Acceptance of Others*

How responsive is the applicant to others' feelings? (0-narrow and unresponsive, 10-exceptionally understanding)

Emotional Stability*

(0-insecure/reactive, 10-secure/stable)

Family Relationships*

(0-poor, 10-excellent)

Flexibility*

How well does the applicant adapt? (0-rigid, 10-consistently able to adapt)

Focus*

Does the applicant have a strong sense of purpose/calling? (0-wavering, 10-strongly committed)

Appearance*

Evaluate the applicant's personal appearance. (0-sloppy, 10-always neat)

Poise*

Evaluate the applicant's public demeanor. (0-lacks confidence, 10-consistently confident)

Leadership*

Is the applicant a leader? (0-never leads, 10-strong leader)

Communication*

Does the applicant present thoughts with clarity? (0-not able to communicate clearly, 10-very articulate)

Ministry Potential*

How would you rate the applicant's probability of success in cross-cultural ministry? (0-poor, 10-excellent)

Relationships with the Opposite Sex*

(0-careless, 10-very discreet)

Comments on any of the above

How long have you known the applicant and in what relationship?*

Does the applicant hold any beliefs that differ from historical evangelicalism?*

YES
NO

If yes, please briefly explain.

Is there anything, in your opinion, that would prevent the applicant from being successfully involved in cross-cultural ministry?*

What would you consider to be the applicant's greatest strengths?*

What would you consider to be the applicant's weak areas?*

Influence on Applicant*

Is there any indication that the applicant's desire for missionary service has been significantly influenced by: A desire for travel or adventure, a desire to exercise power or control over less privileged people or a desire to escape a difficult situation? Explain briefly

Please include any comments you may have on the applicant which you feel have not been covered (or have been inadequately covered) in other sections of this form. Please be frank.

Consent*

By checking this box, I agree that everything is true and accurate.

Signature (Name)*

Date*