Friend/Peer Reference

Team Member Application - Friend/Peer Reference Form

This form is to be completed by a friend or peer as a reference for a team member through a Healing Nations mission trip. All answers are confidential.

Your Name*
First Last
Your e-mail*
Your Phone Number:*
Today's Date*
MM slash DD slash YYYY
Applicant's Name*
First Last
What is your relationship to the applicant?*
How long and well have you known the applicant?*
What are the applicant's strengths?*
In what areas could the applicant improve?*
Have you ever had reason to question the applicant's morals, honesty, etc?*
- Yes
- No
If yes, please explain:
How does the applicant react in new and/or stressful situations?*
Have you ever known the applicant to demonstrate depression, moodiness or withdrawal?*
- Yes
- No
If yes, please explain:
In what ways has the applicant encouraged or influenced you?*
Would you want the applicant on your team?*
- Yes
- No
Please comment:
I recommend the applicant:*
- Without hesitation
- With reservation
- I do not recommend