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Reference Request Form
Step
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4
25%
Name of Applicant
(Required)
First
Last
Name of Reference
(Required)
First
Last
Phone
(Required)
Email
(Required)
Mailing Address
(Required)
In What Capacity Do You Know the Applicant?
(Required)
Relationships
Peer Relationships
(Required)
Average
Awkward
Makes Friends Easily
Strong Friendships
Loner/Avoids Social Relationships
Good Reputation
Poor Reputation
Respects Others
Disrespectful
Sensitive/Considerate
Insensitive
Patient
Quick Tempered
Family Relationships
(Required)
Healthy/Supportive
Healthy/Not Supportive
Unhealthy/Supportive
Unhealthy/Not Supportive
Unknown
Self-Concept
(Required)
Confident
Arrogant
Average
Secure
Insecure
Self-Starter
Needs Encouragement
Character
(Required)
(1 =surface, 10 =very well)
1
2
3
4
5
6
7
8
9
10
Working Relationship
(Required)
Works well with others
Has average ability to work with others
Sometimes has difficulty interacting with others
Has problems relating to fellow workers
Responds to stress/pressure
(Required)
Copes Well
Adapts slowly
Dominates situation
Withdraws socially or emotionally
Becomes overly critical of others
Overreacts
When faced with conflict, this person generally responds
(Required)
(choose all that apply)
Openness to resolving conflict
Peacemaking
Slow to Anger
Confrontation
Defensive/Critical Attitude
Gossips
Lack of Cooperation
Withdrawal/Avoidance
Related to Authority
(Required)
Able to take direction
Does not listen well
Cooperative
Questions authority
Team player
Likes to do their own thing
Respectful of authority
Disrespects authority
Relates well to adults
Sometimes has trouble interacting with adults
Easily confused
Supervisory Needs
Needs little close supervision, only direction
Does well with regular, routine supervision
Needs accountability and encouragement to accomplish tasks/goals
Needs excessive supervision
Spiritual Maturity/Knowledge
Knowledge of the Bible
(Required)
Able to teach others
Regularly studies the Bible
Rarely studies the Bible
Unknown
Stage of Spiritual Growth
(Required)
Spiritually mature
Growing believer
New believer
Spiritually inconsistent
Unknown
Involvement in discipleship
(Required)
(choose all that apply)
Currently discipling others
Currently being discipled
Not in a discipling relationship
Able to disciple others
Unknown
Level of equipping to share the Gospel
(Required)
Equipped to share the Gospel
Needs additional training to share the Gospel
Unequipped to share the Gospel
Unknown
Practice of sharing the Gospel
(Required)
(choose all that apply)
Consistently verbally shares the Gospel
Inconsistently shares the Gospel
Rarely/Never shares the Gospel
Unknown
Applicant’s involvement in a local church
(Required)
Very involved
Rare involvement
Occasionally involved
Not actively involved
Unknown
Skills
Communication Skills
(Required)
Excellent communicator
Average communicator
Struggles to communicate with others
Over communicates
Based on your knowledge of the applicant, what skills and gifts do they possess that are helpful in ministry?
(Required)
Where does the applicant excel? Where does he/she need to grow? Is there other information you think we need to know about the applicant?
(Required)
The Alabama Baptist State Board of Missions upholds the highest standards for people serving with and through our organization. To your knowledge, has the applicant ever been accused of, engaged in, or shared with you about any inappropriate conduct with another person—be it a minor or other adult? (Inappropriate conduct includes but is not limited to, threatening behavior, verbal or sexual harassment, unwanted advances, things such as real or virtual sexual activity, or hate speech?
(Required)
Yes
No
If yes, please explain.
To your knowledge, is there anything in the applicant’s past or present that would hinder their involvement in church related ministry or missions involvement?
(Required)
Name
This field is for validation purposes and should be left unchanged.
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Deadline May 15
