Reference Request

Reference Request

Applicant’s Name *

Applicant's Name

First

Last

Name of person providing reference *

Name of person providing reference

First

Last

Email *

Phone *

Your relationship to the applicant: *

Direct Supervisor

Co-Worker

Pastor/Small Group Leader

OtherOther

How long have you known the applicant? *

The following questions relate to professional experience

1. If you worked with this applicant professionally, briefly describe their responsibilities:

2. Rate the applicant’s relationship with co-workers:

3. Rate the applicant’s relationship with supervisor(s):

4. Did the applicant have any supervisory responsibilities? If so, how many subordinates? Briefly describe management style.

Please check the box that BEST describes your perception of the applicant. Please read through each characteristic before carefully checking the appropriate one.

Integrity *

Lives up to high values

Generally lives up to high values

Inconsistent in lifestyle

Questionable most times

Responsibility *

Diligently follows through

Follows through most of the time

Tends to forget or procrastinate

Unreliable when unsupervised

Initiative *

Looks for things to do

Leads most of the time

Can lead but also follows groups often

Strictly a follower

Cooperation *

Will work with anyone/sensitive to all

Usually works with others

Works with others when convenient

Sees no value in teamwork

Communication (Verbal and Written) *

Very Articulate

Communicates very well

Gets the thought across

Has a difficult time being understood

OtherOther

Respect for Authority *

Continually strives for obedience

Usually obedient to instructions

Inconsistent in response to leadership

Frequently disregards authority

What would you list as the applicant’s greatest strengths or qualities?

As a church, we have ministries that involve children and students. Would you recommend this applicant to care for children or students?

Yes

Unsure

Date *

Time *

Signature *

Clear

If you are human, leave this field blank.

The following questions relate to professional experience

Please check the box that BEST describes your perception of the applicant. Please read through each characteristic before carefully checking the appropriate one.

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