Casas Global Outreach

Confidential Reference for

Short-Term Missionaries

Fillable online form: reference form

 

Casas overflows with joy to send out our church family members to share God’s love outside our comfortable corner of the world. We would appreciate your helping us determine this person’s suitability for a short-term trip and identifying areas that we can help them develop. To be a reference for a person attending a Casas-led or Casas-endorsed short-term trip, we ask that you

 

  • have known the applicant's spiritual walk for at least one year, including the previous six months,
  • fill out this reference form objectively, and
  • avoid making the applicant appear perfect.

 

Applicant Name:

Reference’s Name and Phone:

How long have you known the applicant?

In what capacity have you interactively known the applicant?

How well would you say you know him/her? ___ Not very well; ___ Average;   ___ Very Well

 

Circle or type an X next to the appropriate number on each scale; choose N/A if your knowledge is insufficient in that area.

  1. Comment on the applicant’s sensitivity to the needs, feelings and attitudes of others and ability to work with others.

N/A      1             2                3                4                5                6                7

       INSENSITIVE                                             SOMEWHAT                                                       VERY SENSITIVE

                                                                        SENSITIVE

  1. To your knowledge, how does the applicant respond to change?

N/A      1             2                3                4                5                6                7

        ADAPTS W/                                                  ADAPTS                                            ADAPTS

        DIFFICULTY                                             MODERATELY                                                    VERY WELL
  1. How does the applicant respond to stressful situations?

N/A      1             2                3                4                5                6                7

WITH                                                          HANDLES                                                        HANDLES

DIFFICULTY                                            MODERATELY                                                     WITH SKILL
  1. How does the applicant work with others?

N/A      1             2                3                4                5                6                7

COOPERATES                                       COOPERATES                                                    COOPERATES

POORLY                                                  MODERATELY                                                VERY WELL

 

Circle or type an X next to the appropriate number on each scale; choose N/A if your knowledge is insufficient in that area.

N/A      1             2                3                4                5                6                7

CRITICAL                                                    NEUTRAL                                                       CONSTRUCTIVE

N/A      1             2                3                4                5                6                7

IRRITABLE                                                   NEUTRAL                                                       EASYGOING

N/A      1             2                3                4                5                6                7

WORRIED/ANXIOUS                                     NEUTRAL                                                       TRANQUIL

N/A      1             2                3                4                5                6                7

DEPRESSED                                                NEUTRAL                                                       JOYFUL

N/A      1             2                3                4                5                6                7

DOMINEERING                                            NEUTRAL                                                       RESPECTFUL

N/A      1             2                3                4                5                6                7

REBELLIOUS                                               NEUTRAL                                                       LOYAL

N/A      1             2                3                4                5                6                7

ANGRY                                                       NEUTRAL                                                       CALM

Please answer the following questions.

  1. How does the applicant respond to authority?
  2. Do you have any reservations about this person participating in a global short-term trip? ❏ Yes ❏ No    If yes, please explain.

 

Signature (if mailing printed form) and Date: 

 

If submitting by mail, please print and return it in a sealed envelope to:  Casas Global Outreach, 10801 N La Cholla Blvd., Tucson, AZ  85742

 

Or email to casasglobaloutreach@gmail.com or fax to (520) 878-1211