This document is a reference form for an applicant to Youth With A Mission-Nashville. The form requests information about the applicant from a reference such as how well they know the applicant, their relationship to them, and ratings and comments on traits like initiative, self-discipline, ability to work with others, and personal devotions. The reference is also asked their recommendation for whether the applicant should be accepted, and if a two-year missionary commitment would be beneficial.

1. General Reference Form
TO THE APPLICANT: Please complete the information below and provide a stamped envelope addressed to:
Youth With A Mission-Nashville: Personnel Department – P.O. Box 58 – Adams, TN 37010
Name of Applicant: _______________________________________________ Phone #: ___________________________
Street Address: _______________________________________ City: ________________ State: _____ Zip: ___________
Applying For: _____________________________________________________ Date Beginning: ____________________
I, the above named applicant, waive any right I have to read or obtain copies of this recommendation knowing that this
waiver is not required as a condition for admission.
Applicant’s Signature: _______________________________________________________ Date: ____________________
FOR REFERENCE ONLY
The above applicant has applied for admission to Youth With A Mission – Nashville. Serious consideration will
be given to your comments. Therefore, we ask that you complete this form carefully. Your early response will be most
appreciated as the applicant’s file cannot be considered until all forms have been received by this office. Thank you
for taking time to help us in this way. We sincerely appreciate your cooperation.
Please check the following and comment where necessary:
Your relationship to the applicant: □ Parent □ Employer □ Teacher □ Friend □ Other: ___________________________
How well do you know the applicant?: □ Very Well □ Well □ Casually □ Not Well
Please rate the following and provide comments where necessary:
Excellent Good Fair Poor No Observation
Initiative □ □ □ □ □
Self – Discipline □ □ □ □ □
Self – Image □ □ □ □ □
Ability to Work with Others □ □ □ □ □
Concern for Others □ □ □ □ □
Desire to Serve □ □ □ □ □
Social Acceptability □ □ □ □ □
Work Ethic □ □ □ □ □
Dependability □ □ □ □ □
Emotional Stability □ □ □ □ □
Judgment / Decision Making □ □ □ □ □
Adaptability □ □ □ □ □
Ability to Follow □ □ □ □ □
Ability to Lead □ □ □ □ □
Financial Stewardship □ □ □ □ □
Personal Devotions □ □ □ □ □
Perseverance □ □ □ □ □
Additional Comments: _______________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

2. 1. How long have you known the applicant?: __________ years
2. How long have they attended your church?: __________ years
3. Were you aware of the applicant’s intention to join us on staff? □ No □ Yes
4. Please describe the applicant’s work ethic: ________________________________________________________
___________________________________________________________________________________________
5. Describe the applicant’s ability to work with others: ________________________________________________
___________________________________________________________________________________________
6. Please comment on the applicant’s strengths and gifting’s: ___________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
7. Is the applicant’s personal walk with the Lord:
□ Zealous □ Bold □ Reserved □ Unknown
Please explain: _______________________________________________________________________________
___________________________________________________________________________________________
8. Please comment on the applicant’s family background (if known): ______________________________________
___________________________________________________________________________________________
9. What is your recommendation for the applicant?
□ To be accepted on staff □ Not to be accepted on staff
Is your recommendation:
□ Strong □ Moderate □ Hesitant
10. Does the applicant seem to have any mental or emotional disabilities?: □ No □ Yes
If yes, please explain:__________________________________________________________________________
___________________________________________________________________________________________
11. Can you give any other information concerning applicant that might aid us in our decision?:
___________________________________________________________________________________________
___________________________________________________________________________________________
12. Do you think that (at least) a two-year commitment to missionary service would be beneficial, or unwise at this
point to the applicant? □ Beneficial □ Unwise
Please explain: _______________________________________________________________________________
___________________________________________________________________________________________
FOR REFERENCE ONLY
Name: _________________________________________ Title: ___________________ Phone #: ___________________
Address: _________________________________________ Email: ____________________________________________
City: _________________________________________ State: ___________________ Zip Code: ____________________
Signature: _______________________________________________________________ Date: _____________________
Would you like to receive further information about YWAM – Nashville? □ No □ Yes