STUDENT'S CONFIDENTIAL REFERENCE FORM

To be filled out by: a) Your PASTOR b) A FRIEND c) A PARENT / GUARDIAN

The APPLICANT: Please complete the information below and give it to each of your referees.

Name of APPLICANT: ______________________________________________________

APPLICANT'S SIGNATURE: _____________________________ DATE: _____________

ADDRESS: ______________________________________________ CITY: ____________

SPECIFY SCHOOL APPLYING FOR: __________________________________________

MONTH and YEAR

 

The above applicant has applied for admission to a Youth With A Mission (YWAM) training

program.YWAM is an international, interdenominational Christian mission-oriented organisation.

Founded in 1960, it now has 552 centers in over 133 Nations on all six continents. Its purposes

include training, challenging and channeling Christians to fulfill Christ's command: "Go, therefore,

and make disciples of all nations". Mercy Ministries to the refugees of the world have become

an additional burden and reality. The University of the Nations is a training and logistics base

from which skilled workers are sent out. The DTS is the pre-requisite to the University of the

Nations Schools', which is run worldwide. In order to make an intelligent evaluation of the

applicant's fitness for admission to this training program, it would be appreciated if you could

supply the information requested here. Serious consideration will be given to your comments,

therefore we ask that you complete this form carefully.

Thank you for taking the time to help us in this way.

PLEASE CHECK THE FOLLOWING AND COMMENT WHERE NECESSARY.

1. How well do you know the applicant? Very well []; Well []; Casually [].

 

2. What is your relationship to the applicant?

Employer []; Teacher []; Pastor []; Friend []; Other [] (specify) _____________

 

3. Please circle what best describes the applicant

(1=Superior 2=Above Average 3=Average 4=Below Aaverage 5=Inferior)

 

Initiative: 1 2 3 4 5

Social adaptability: 1 2 3 4 5

Concern for others: 1 2 3 4 5

Ability to Follow: 1 2 3 4 5

Leadership: 1 2 3 4 5

Judgment/Decision Making: 1 2 3 4 5

Emotional stability: 1 2 3 4 5

Health: 1 2 3 4 5

Personal Appearance: 1 2 3 4 5

 

Additional Comments: ________________________________________________________

 

 

4. Please tick which answer best describes the Applicant:

Mental ability: Quick to Comprehend []; Average []; Slow [].

Industry: Hard Worker []; Average []; Lacks persistence [].

Reliability: Meets obligations []; Average []; Neglects obligations [].

Co-operative: Works well with others []; Average []; Avoids group activity [].

Flexibility: Open to change []; Average []; Unyielding [].

Christian Character: Well balanced []; Average []; Unstable[].

Disposition: Cheerful []; Average []; Passive [].

Punctuality: Punctual []; Average []; Often late [].

Financial responsibility: Honors obligations []; Average []; Neglectful [].

Additional Comments:____________________________________________________________

_______________________________________________________________________________

5. Is the applicant active in church work? Yes []; No [].

 

6. Does he/she display high moral standards? Yes []; No [], If no, please explain: _______________________________________________________________________________

 

7. Is he/she prejudiced against groups, races or nationalities? Yes []; No [] -

If yes, Please explain: ______________________________________________________________

 

8. With reference to his/her Christian service, do you consider the applicant to be:

Dedicated []; Average []; Casual [] - Please explain: ______________________________________

 

9. In your consideration, which of the following would best describe the applicant's experience?

Mature []; Contagous []; Genuine & Growing []; Superfical []; Over-Emotional [];

Additional Comments: _____________________________________________________________

 

10. Please comment on the applicant's family background (if known): ________________________________________________________________________________

 

11. Please add any other relevant remarks: ___________________________________________

 

12. Would you recommend the applicant for acceptance by YWAM?

Yes []; With some Hesitation []; No [] - If no, please explain: _______________________________

 

13. How well does the applicant speak and write the English language? ___________________

 

14. I have known: _____________________________________________ for _______ years

and believe that he/she possesses the qualities indicated above.

TITLE: _____ NAME: ___________________________________________________________

ADDRESS: ____________________________________________________________________ ______________________________________________________________________________

TEL: __________________ FAX: __________________ EMAIL: _______________________

SIGNED: ___________________________________________ DATE: ___________________

 

Would you like to receive further information about YWAM? Yes []; No [].

Thank you for your assistance.