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CMIT Program Applicant Reference
Applicant's Name
*
First
Last
The person listed above is applying to offer a nationally approved Campus Missionary-In-Training internship within his/her local Chi Alpha Campus Ministry. Please provide your opinions of this person offering a year-long internship. This reference will be kept confidential.
Your Name
*
First
Last
Your Position/Title
*
Your Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Your Phone Number
*
Your Email
*
How do you know the applicant?
*
How long have you known the applicant?
*
How would your at the applicant in the following qualities using the following key to evaluate. Please comment.
1 = No Observation
2 = Below Average
3 = Average
4 = Very Good
5 = Exceptional
Analytical ability, good judgment, thinks strategically
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's analytical ability, good judgment, and strategically thinking.
Willing to make decisions
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's willingness to make decisions.
Self-confident, self-assured
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's self-confidence and self-assurance.
Integrity in word and deed
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's integrity in word and deed.
Honest, truthful, non-deceitful
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's honesty, truthfulness, and non-deceitfulness.
Open with peers and overseers
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's openness with peers and overseers
*
Verbal communication skills
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's verbal communication skills.
Work habits, prompt, thorough
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's work habits, promptness, and thoroughness.
Emotional stability
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's emotional stability.
*
Desires to lead
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's desire to lead.
Willing to assume responsibility
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's willingness to assume responsibility.
Ability to get along with others
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's ability to get along with others.
*
Attitude towards authority
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's attitude towards authority.
Gains cooperation from others
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's gains in cooperation from others.
Sets challenging personal goals
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's personal goals.
Takes initiative, is proactive
*
1 - No Observation
2 - Below Average
3 - Average
4 - Very Good
5 - Exceptional
Comment on the applicant's initiative and proactiveness.
What is your assessment of the applicant’s fitness and suitability for working with a religious organization? Please state your estimation of the applicant’s character, capacity and motivation for vocational ministry.
*
Do you have any reservations regarding the applicant’s fitness and suitability for working with a religious organization?
*
Recommendation
*
I highly recommend this applicant.
I recommend this applicant to an internship-training program.
I do not recommend this applicant to an internship-training program.
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