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Parents/Guardians Reference Form for Youth Mission Trip
This form is for the parents and guardians of youth applying to the Fellowship's Mission Trip. If you are not a parents/ guardians please fill out the general reference form also on the website. Please fill out as accurately as possible.
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* Indicates required question
Name of Applicant
*
Your answer
Parents: are you in support of your child going on this trip?
*
Yes
No
Maybe
Other:
If no, please explain why?
Your answer
How well do you know the applicant?
*
Your answer
What do you consider to be his/her strengths and talents?
*
Your answer
What do you consider to be his/her areas where personal development is needed?
*
Your answer
Would you consider him/her to be of high moral character?
*
Yes
No
Maybe
Sometimes
Other:
If you feel an explanation is needed, please explain.
Your answer
Describe the applicant's attitude toward authority and responsiveness toward instruction?
*
Your answer
Please comment on the following areas
Omit those about which you have insufficient knowledge to form an opinion. Again, please be as accurate as possible.
Interpersonal Relationships
Cooperation teachable spirit, Conflict resolution, Motivational skills.
Your answer
Creative, Initiative
Your answer
Personal Appearance, Attitude, Acceptance by others
Your answer
Capacity for Learning, Understanding
Your answer
Communication Skills
Your answer
Please grade the candidate in the following areas
1 being poor or in need of work and 5 being excellent/an example to others. Please leave blank what you can not comment on.
Integrity
1
2
3
4
5
Clear selection
Loyalty
1
2
3
4
5
Clear selection
Friendliness
1
2
3
4
5
Clear selection
Dependability
1
2
3
4
5
Clear selection
Enthusiasm
1
2
3
4
5
Clear selection
Leadership
1
2
3
4
5
Clear selection
Self Starter
1
2
3
4
5
Clear selection
Capacity for Work
1
2
3
4
5
Clear selection
Emotional Stability
1
2
3
4
5
Clear selection
Tact
1
2
3
4
5
Clear selection
Ability to Work with Others
1
2
3
4
5
Clear selection
Willingness to Take Criticism
1
2
3
4
5
Clear selection
Honesty
1
2
3
4
5
Clear selection
Punctuality
1
2
3
4
5
Clear selection
Other remarks:
Your answer
Would you commend on any reason why this applicant should not be considered for this trip?
Your answer
Do you recommend the applicant for this ministry?
Your answer
Additional comments:
Your answer
Signature and date need to add
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