Spokane Master's Commission Confidential Reference

First Church of the Open Bible 8303 N. Division Spokane, WA 99208 (509)467-5122

Student Information
Name:		Date:
This form is to be completed by your pastor and mailed directly to our office. If your father is your pastor, please refer the form to the assistant pastor or youth pastor in your church. If a person other than your pastor (assistant pastor or youth pastor) completes the form, an explanation should be provided.
Instructions
The above applicant has applied to become a disciple in Spokane Master’s Commission. We would appreciate it if you would supply the information requested on this form in order to aid us in evaluating the applicants suitability to work with us. The applicant cannot be considered until all reference forms are received, therefore your speedy completion of this form would be very much appreciated.  When finished, please mail it directly to the Master’s Commission office at the address listed at top. This reference will be kept in confidence. Thank you for your assistance.

About the Applicant
1. How long have you known the applicant?
2. How long has the applicant attended your church?
3. How well do you know the applicant?
____Very close       ____ Fairly close       ____ Casually       ____ By name / sight
4. In your association with the applicant, what has been the level of commitment you have seen exemplified?
____Faithful       ____ Inconsistent       ____ Other ______________________________________________
5. Evaluation of applicant’s emotional maturity (please check one):
___ Outstandingly mature. Has proven his/her ability to operate under stress. ___ More mature and emotionally stable than average. ___ Possesses adequate emotional stability and maturity. ___ Experience has shown that the applicant might not be able to endure under stress. ___ Applicant has frequently demonstrated signs of inability to cope with stress, such as rage or withdrawl, can be errattic in attitude and action, or has demonstrated instability in other ways. Comments:
6. How does the applicant usually react in trying situations:
___ Withdraws ___ Gets Discouraged ___ Gets angry ___ Accepts patiently ___ Meets constructively     ___ Other: _______________________________________________________________________
7. Has the applicant proven on any occasion to be unreliable, dishonest, or of questionable character?
___ Yes ___ No If yes, explain:
8. As far as you know, has the applicant ever been arrested for any offense?
___ Yes ___ No If yes, explain:
9. Please check the words that describe the applicant (choose only a few that stand out):
___ Teachable ___ Nervous ___ Flexible ___ Moody ___ Easily discouraged ___ Dependable ___ Committed ___ Humorous ___ Anxious ___ Understanding ___ Tolerant ___ Wise ___ Critical ___ Perfectionist ___ Domineering ___ Enthusiastic ___ Patient ___ Motivated ___ Disciplined ___ Easily offended ___ Good listener ___ Stable ___ Peaceful ___ Prejudiced ___ Easily embarassed ___ Kind ___ Lacking humor ___ Servant's heart
10. In your opinion, which of the following areas of ministry does the applicant seem gifted?
___ Prayer ___ Electrical ___ Carpentry ___ Medical ___ Administration ___ Computers ___ Hospitality ___ Encourager ___ Plumbing ___ Communication ___ Drama ___ Laboring ___ Discipleship ___ Evangelism ___ Welding ___ Art ___ Secretarial ___ Teaching ___ Worship ___ Children’s Work ___ Dance ___ Music ___ Counseling ___ Other: ______________________________
11. Evaluation of the applicants characteristics (please check one in each group)
PHYSICAL CONDITION   WILLINGNESS TO SERVE   RELATIONSHIPS ___ Frequently incapacitated   ___ Reluctant to serve   ___ Avoided by others ___ Below average   ___ Confused motives   ___ Tolerated by others ___ Fairly healthy   ___ Usually willing to serve   ___ Liked by others ___ Good health   ___ Eager to serve as needed   ___ Well liked by others ___ Rugged and vigorous               INTELLIGENCE   LEADERSHIP ABILITY   CHRISTIAN EXPERIENCE ___ Learns and thinks slowly   ___ Makes no effort to lead   ___ Relatively superficial ___ Average mental ability   ___ Tries but lacks ability   ___ Overemotional ___ Alert, has a good mind   ___ Has some leadership ability   ___ Genuine but mild ___ Brilliant, exceptional   ___ Good leadership ability   ___ Genuine and growing       ___ Unusual ability to lead   ___ Warmly contagious   TEAMWORK   RESPONSIVE TO AUTHORITY   ACHIEVEMENT ___ Frequently causes friction; insisting on own way   ___ Slow to sense how others feel   ___ Does only what is assigned ___ Usually cooperative   ___ Reasonably responsive   ___ Starts but doesn’t finish ___ Works well with others   ___ Usually responsive and understanding   ___ Meets expectations ___ Exceptional Teamwork   ___ Understanding and thoughtful   ___ Takes initative
12. Do you recommend the applicant for acceptance as a Master’s Commission disciple?
___ Yes, without reservation ___ Yes, with hesitation ___ No

About Yourself
Name:		Address:
City:		State:		Zip:		Phone	(        )
Name of Church and Denomination:
Position in church:

 

Signature:		Date:
Sep 05, 2008