Outpost Reference Form

Your Name*

First Last

I am acting as a reference for:*

How long have you known the applicant?*

What is your relationship with the applicant?*

Your relationship to the applicant is such that you would have firsthand knowledge of they (check all that apply):*

Does the applicant give evidence of a love for the Word of God?*

Does the applicant give evidence of a prayer life?*

Does the applicant seek fellowship with other Christians?*

Does the applicant show patience with weaknesses of others?*

Does the applicant attend church on a regular basis?*

Please make comments on the applicant’s spiritual life or anything else you feel we should know about him/her.

Please assess the applicant by checking all that apply under each heading below:

Sociability or Friendliness*

Leadership*

Teamwork*

Achievement*

Sensitivity to Others*

Emotional Stability*

Self-Image*

Teachability*

Please take the time to explain any of the above answers as needed:

What evidence do you see in the applicant's life of a growing relationship with Christ?*

What do you believe to be the applicant's motivation in applying to the Outpost program?*

Why do you recommend the applicant for the Outpost program?*

If there are others with whom we should talk about the applicant, please give names, phone numbers and/or email addresses.

Signature*