Pastoral Reference Form

The applicant below has applied to serve as a missionary with Cambodia Mission Outreach (CMO). We are a locally run ministry dedicated to educating the poor, preaching the Gospel, and raising up nationals for Christian leadership. While serving with CMO, the applicant will have the opportunity to put forth their skills, gifts, and services to advance the kingdom of God here in Cambodia. Our working, and living, conditions may be basic and could prove stressful to some, so it is in the best interest of the applicant that your reference is not overly optimistic, but realistic. Serious consideration will be given to your comments, therefore we ask that you complete this form carefully. 
1. Name of Applicant:
2. How well do you know the applicant? Very well
Well
Casually
3. To what extent is the applicant active in church service?
4. Does he/she display high moral standards? Yes
No
Explain:
5. With regard to his/her Christian service, do you consider the applicant to be: Dedicated
Average
Casual
6. In your consideration, which of the following would best describe the applicant’s Christian experience? Mature
Genuine and growing
Minimal, but constant
Immature
Comments:
7. What could CMO do to aid in the applicant’s personal and Spiritual development?
8. Where do you see areas, in the applicant’s life, that require growth?
9. What growth have you, personally, observed?
10. What do you consider to be the applicant’s areas of strength?
11. Would you enjoy having this person work under/with you?
12. If the applicant is married, how would you describe his/her relationship with their spouse (and children, if applicable)?
13. Why, in your opinion, is the applicant applying to serve with CMO?
14. Do you have any reservations about recommending the applicant to serve in Cambodia with CMO?

15. Please check the appropriate box:

Initiative Unknown
Poor
Fair
Good
Excellent
Cultural Adaptability Unknown
Poor
Fair
Good
Excellent
Concern for others Unknown
Poor
Fair
Good
Excellent
Acceptance of correction Unknown
Poor
Fair
Good
Excellent
Leadership Unknown
Poor
Fair
Good
Excellent
Self Esteem Unknown
Poor
Fair
Good
Excellent
Health Unknown
Poor
Fair
Good
Excellent
Honesty Unknown
Poor
Fair
Good
Excellent
Financial Responsibility Unknown
Poor
Fair
Good
Excellent
Moral Character Unknown
Poor
Fair
Good
Excellent
Humility Unknown
Poor
Fair
Good
Excellent
Able to work with others Unknown
Poor
Fair
Good
Excellent
Flexibility Unknown
Poor
Fair
Good
Excellent
Responsible Unknown
Poor
Fair
Good
Excellent
16. I fully believe the applicant possesses the qualities indicated in this form: Yes
No
17. Name:
Date:
Position:
Address:
Phone #:
Email Address:

Thank You!


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