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Small Groups Reference Form
Thank you for taking a few minutes to complete the following reference form. Your comments will be a major factor in assessing the suitability of the applicant for leading a Small Group at Water of Life Church. All information will be treated as strictly confidential, and will not be seen by the applicant.
Prospective Small Group leader's name:
*
Your name:
*
Your day time phone number:
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###
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Email
*
Are you writing this reference as the applicant's Pastor or friend?
Pastor
Friend
BACKGROUND INFORMATION
What is your relationship to the applicant?
In a few words, how would you describe his/her general character?
How long have you known him/her?
PERSONAL ATTRIBUTES
Please assess thee applicant's personal character attributes on a scale of 1 (weak) to 5 (outstanding). If you have not had enough experience with the individual to answer the question, please leave it blank.
Marriage and family relationships.
weak
1
2
3
4
5
outstanding
Personal discipline.
weak
1
2
3
4
5
outstanding
Moral character.
weak
1
2
3
4
5
outstanding
Emotionally stable.
weak
1
2
3
4
5
outstanding
Self confident.
weak
1
2
3
4
5
outstanding
Reliable.
weak
1
2
3
4
5
outstanding
Trustworthy.
weak
1
2
3
4
5
outstanding
Compassionate and caring for others.
weak
1
2
3
4
5
outstanding
A person of integrity.
weak
1
2
3
4
5
outstanding
Ability to accept correction graciously.
weak
1
2
3
4
5
outstanding
Ability to learn new ways of doing things.
weak
1
2
3
4
5
outstanding
Ability to function within guidelines.
weak
1
2
3
4
5
outstanding
Ability to work in a team environment.
weak
1
2
3
4
5
outstanding
FOR HEALTH OR FITNESS LEADERS ONLY: Is skilled and knowledgeable for leading a health or fitness group.
weak
1
2
3
4
5
outstanding
If you have additional comments that would be helpful, please add them here:
*
INVOLVEMENT WITH CHILDREN AND/OR SEXUAL MISCONDUCT
Have you ever observed him/her interacting with children?
*
yes
no
Other
Would you feel comfortable leaving your own children with him/her?
*
yes
no
Other
To your knowledge, has he/she ever been accused of any form of sexual impropriety or contact with any adult or child?
*
yes
no
Other
OTHER COMMENTS
What are the applicant's weaknesses?
What are the applicant's strengths?
Other concerns or comments:
How strongly do you recommend the applicant for Small Group leadership?
*
Strongly, without reservation
I recommend him/her, but with slight reservations
I have some significant concerns with him/her as a leader
I would not recommend this person for Small Group Leadership at this time
Other
THANK YOU FOR YOUR INPUT!
We greatly appreciate your time and thought as you filled out this reference. If you have any other questions or concerns, please contact Small Groups at smallgroups@wateroflifecc.org or (909) 463-0103.