Character Reference Form

Page 1

Keap Tags

Tag

Name

First Name

Last Name

Email

Please select in what capacity you are filling in this form. (If you are unsure, please refer to the email you received with the link to this form.)

Reference Applicant

Instructions for completing this section

Your Name

First Name

Last Name

Your Age

E-mail

Address

Street Address

City

State / Province

ZIP / Postal Code

Phone Number

May we contact you if necessary?

Yes No

What would be the best time to contact you?

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How long have you known the applicant?

How well do you know the applicant?

Slightly Moderately Very Well

What is your relationship to the applicant?

Page 3

Ability to receive correction

Self-Confidence

Self-Esteem

Ability to make decisions

Social ability

Concern for others

Ability to lead

Ability to follow

Willingness to serve

Emotional stability

Communication skills

Stewardship

Personal hygiene

Are there any additional comments you would like to make about the answers you have given?

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Mental Ability

Work Ethic

Follow-through

Teamwork

Flexibility

Christian character

Attitude

Punctuality

Financial responsibilty

Are there any additional comments you would like to make about the answers you have given?

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1. Which if the following best describe the applicant's Christian experience?

2. Does the applicant display high moral standards?

Yes No

If no, please explain

3. How does the applicant usually react in trying / difficult situations?

If other, please explain

4. Does the applicant struggle with (or has struggled with) drugs, alcohol, smoking, pornography, mental illness.

Yes No

If yes, please explain

5. What are some of the applicant's strengths? (include any special abilities / talents)

6. What are some of the applicant's weaknesses?

7. Where do you see the applicant thriving in ministry? (with children, youth, music, mercy, etc.)

8. Has the applicant proven, on any occasion, to be unreliable, dishonest, or of questionable character?

Yes No

If yes, please explain

9. Do you recommend the applicant for acceptance with Marine Reach?

Yes No

Please explain your answer

10. Any additional comments to help us determine the applicant's suitability for this program?

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I consent to submitting my personal information to Marine Reach for the purposes of processing this Character Reference Form.

Yes, I consent No, I do not consent

Signature

Date

Page 7

Thank you for completing this form.

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