TruNorth Reference Form

Thank you for taking the time to complete this reference form. We look forward to hearing from you and appreciate your time. Once you have completed the reference form and hit the submit button, it will be sent to us and will be confidential. We value your honest input and would love to talk further if needed. Please feel free to reach out to the TruNorth director, Justin Olson at justinols@fortwilderness.com

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Applicant

Name of applicant

First Last

Relationship to applicant

How long have you known applicant?

On a scale of 1-5 (1 is low, 5 is high), how well do you feel you know the applicant?

5 (High)

1 (Low)

In your opinion, which of the following would best describe the applicant's Christian faith?

Mature

Genuine and growing

New Christian

Nominal

Applicant's Profile

On a scale of 1-5 (1 is low, 5 is high), please rate the applicant in the following area. If you have more feedback on any specific area, please use the space below to elaborate.

Concern for others

5 (High)

1 (Low)

Emotional stability

5 (High)

1 (Low)

Cooperation

5 (High)

1 (Low)

Follows directions

5 (High)

1 (Low)

Response/attitude toward authority

5 (High)

1 (Low)

Initiative

5 (High)

1 (Low)

Teachability

5 (High)

1 (Low)

Flexibility & Accepting new ideas

5 (High)

1 (Low)

Additional comments

Please rate the applicant as to his/her maturity, stability, ability to handle stress.

Outstanding-mature. Has proven his/her ability to operate under stress and pressure

More mature and emotionally stable than average

Possesses adequate emotional stability and maturity

Doubtful- Experience has shown that the applicant might not be able to endure stress

Applicant has frequently demonstrated sighs of inability to cope with stress such as rage or withdrawal, is erratic in attitude and action or has demonstrated emotional instability in other way

In your opinion, in which of the following areas of ministry is the applicant gifted? Please choose all that apply:

Communication

Media

Servant hearted

Art

Teaching

Hospitality

Worship

Encourager

Discipleship

Drama

Preaching

Medical

Counseling

Evangelism

Administrator

Children’s work prayer

Pastoring

Music

What do you see as the applicant’s area of strength?

Problem Areas

We are seeking to help the applicant grow. Please check any that apply to the applicant.

Anxious/frequently worries

Prone to depression

Intolerant

Nervous or tense

Critical of others

Impatient

Argumentative

Addictive behavior

Easily embarrassed or offended

Easily discouraged

Domineering

Given to moods

Erratic in attitudes or actions

If you've noticed any of these attitudes in the applicant’s life, please elaborate.

To your knowledge, how does this applicant respond to conflict?

Avoidant

Confrontational

Stubborn/head strong

Passive aggressive

Explosive

Passive/stuffs feelings down

Mature/able to maintain relationship

If you have noticed any of these negative attitudes in the applicant’s life, please give an example.

To your knowledge, what is the applicant’s working style?

Hard-working

Methodical

Easy going

Stubborn and strong willed

Avoidant

Lazy

Distracted

Unmotivated

Inflexible

Untrustworthy

Please give an example of this style.

To your knowledge, what is the applicant’s relationship with social media?

What is your overall recommendation of the applicant’s suitability to the TruNorth program?

Exceptional

Above-average

Average

They are good, but I have some reservations

Unfit at this time

Definitely unfit

Do you have any other comments regarding the applicant?

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