Page 6—Short-term Trip Reference Form

Note that all information provided is confidential and will not be divulged to the applicant. If a trip application is denied based upon information you provide, the applicant will be referred to you for details.

Short-term Mission Trip Applicant:

Reference Provided by:

Trip Applied for:

How long have you known this person, and in what context?

What is your assessment of the applicant's ministry?

What is your assessment of the applicant's relationships (friendships, marriage, etc.)?

Do you foresee any potential problems with this person's interaction with the opposite sex during this trip? Have you observed any existing problems at home?

How does this person respond to unfamiliar people or surroundings?

How well do they work on a team?

Describe the applicant's

1. Strengths/Potential Contributions
   
   
   
2. Weaknesses/Potential Problems
   

Do they have experience with any of the following:

Leading someone to Christ
Yes
No
Don't know

Bible teaching
Yes
No
Don't know

Discipling others
Yes
No
Don't know

Missions training or experience
Yes
No
Don't know

Leading a Ministry Team or Home Group
Yes
No
Don't know

Other:

Please consider each trait as it would describe this person at this time:

Friendliness

Poor			Excellent
1	2	3	4	5

Works well on a team

Poor			Excellent
1	2	3	4	5

Leadership

Poor			Excellent
1	2	3	4	5

Speaking Ability

Poor			Excellent
1	2	3	4	5

Initiative

Poor			Excellent
1	2	3	4	5

Considerate of others

Poor			Excellent
1	2	3	4	5

Adaptability

Poor			Excellent
1	2	3	4	5

Dependability

Poor			Excellent
1	2	3	4	5

Bible Knowledge

Poor			Excellent
1	2	3	4	5

Servant Attitude

Poor			Excellent
1	2	3	4	5

Fitness/Health

Poor			Excellent
1	2	3	4	5

Zeal

Poor			Excellent
1	2	3	4	5

 

Do you recommend this person for this trip?
Why?

Please ensure you have responded to every question above or your reference will not be submitted.