Reference Form

Reference Form

For Staff and Volunteer Applicants
Your Name*

First NameLast Name
Your Cell Phone Number*
Format: (000) 000-0000.
Your Email*
example@example.com
Who are you giving a reference for?

First NameLast Name
How do you know this person?
For how long have you known this person?
Please describe this person's ability to work with youth:
Please describe this person's ability to work with adults:
What particular gifts does this person bring to the ministry of Street Hope TN?
Do you feel this applicant has any problems or limitation which would impede on her/his serving at Street Hope TN?

Relates Well with Youth

	1	2	3	4	5

1 is Weak, 5 is Strong

Relates Well with Adults

	1	2	3	4	5

1 is Weak, 5 is Strong

Honest and Open in Relationships

	1	2	3	4	5

1 is Weak, 5 is Strong

Reliable

	1	2	3	4	5

1 is Weak, 5 is Strong

Ability to Receive Criticism

	1	2	3	4	5

1 is Weak, 5 is Strong

Ability to Work as Part of a Team

	1	2	3	4	5

1 is Weak, 5 is Strong

Ability to Take Initiative and Complete a Project

	1	2	3	4	5

1 is Weak, 5 is Strong

Ability to Express Oneself

	1	2	3	4	5

1 is Weak, 5 is Strong

Any additional comments about this applicant you would like to share:
I agree that the information I have given is the best of my knowledge.*

I understand.
Date

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Date
Signature*

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