Church Leader Please enable JavaScript in your browser to complete this form.Youth With A Mission (YWAM) is a worldwide inter-denominational missionary organisation. It provides opportunities for voluntary Christian service on a short or long term basis. The applicant has given your name as a referee. In accordance with the UK Data Protection Act 1998, please confine your answers to what you know of the applicant from your own experience. • Please complete this reference and email it to admin@ywamliverpool.co.uk . If you would prefer to give additional comments by telephone, please feel free to ask to arrange a call. • We would appreciate it if you would keep this confidential and not give it back to the applicant unless it’s in a sealed envelope. • In order to adequately evaluate the applicant for admission to YWAM (location) we would appreciate you supplying the information requested in this form as openly and honestly as you can. Your statement will help us to effectively meet the needs of the applicant should their application be successful. • Receipt of this form is necessary before we can consider the application. Thank you for taking the time to complete this reference on the applicant’s behalf. RELATIONSHIP TO THE APPLICANTNAME OF APPLICANT:WHAT IS YOUR RELATIONSHIP WITH THE APPLICANT?PASTOR / MINISTER / CHURCH ELDEROTHER CHRISTIAN LEADEROTHER CHRISTIAN LEADERHOW LONG HAVE YOU KNOWN THE APPLICANT?ON A SCALE OF 1-10, HOW WELL DO YOU KNOW THE APPLICANT? (1 VERY LITTLE - 10 EXTREMELY WELL)CHRISTIAN EXPERIENCEWHAT HAS BEEN THE APPLICANT’S LEVEL OF COMMITMENT TO YOUR CHURCH?FAITHFULINCONSISTANTOTHEROTHERIN YOUR OPINION, WHICH OF THE FOLLOWING WOULD BEST DESCRIBE THE APPLICANT’S CHRISTIAN EXPERIENCE? PLEASE TICK ALL THAT APPLY.NEW BELIEVERGENUINE AND GROWINGSUPERFICIALOVER-EMOTIONAL/SELF FOCUSEDVARIABLE/INCONSISTENTMATUREOPENLY SHARES FAITH WITH OTHERSUNMOTIVATEDPLEASE EXPAND:EMOTIONAL STABILITY PLEASE SELECT ONE STATEMENT THAT BEST SUITS THE APPLICANT’S MATURITY AND STABILITY AND PLEASE COMMENT ON IT.OUTSTANDING - MATURE. HAS PROVEN THEIR ABILITY TO OPERATE UNDER STRESS AND PRESSUREMORE MATURE AND EMOTIONALLY STABLE THAN AVERAGEPOSSESSES ADEQUATE EMOTIONAL STABILITY AND MATURITYDOUBTFUL - EXPERIENCE HAS SHOWN THE APPLICANT MIGHT NOT BE ABLE TO ENDURE STRESSFUL SITUATIONSAPPLICANT HAS FREQUENTLY DEMONSTRATED SIGNS OF INABILITY TO COPE WITH STRESS SUCH AS RAGE OR WITHDRAWAL; IS ERRATIC IN ATTITUDE & ACTION; HAS DEMONSTRATED EMOTIONAL INSTABILITY IN OTHER WAYSOTHER - PLEASE SPECIFY:PLEASE EXPANDCHALLENGING SITUATIONSHOW DOES THE APPLICANT USUALLY RESPOND TO CHALLENGING SITUATIONS? PLEASE COMMENT BELOW.WITHDRAWSHOLDS OFFENSEGETS ANGRY/COMPLAINSGETS DISCOURAGEDGIVES UPACCEPTS PATIENTLYMEETS CONSTRUCTIVELYRISES TO THE CHALLENGEOTHER - PLEASE SPECIFYPLEASE EXPAND:AREAS FOR GROWTHPLEASE CHECK WORDS OR DESCRIPTIONS IF THEY APPLY TO THE APPLICANT, THEN COMMENT BELOW. PLEASE NOTE THAT WE ARE SEEKING TO HELP THE APPLICANT GROW.ANXIOUS / FREQUENTLY WORRIEDIMPATIENTINTOLERANTARGUMENTATIVEDOMINEERINGNERVOUS / TENSEREBELLIOUSSOCIALLY AWKWARDLOW SELF-ESTEEM / LACK OF SELF-CONFIDENCEIMMATUREMOODYCRITICAL OF OTHERSEASILY OFFENDEDERRATIC ATTITUDES OR ACTIONSADDICTIVE BEHAVIOURUN-TEACHABLECLOSED / “LONER”PREJUDICED TOWARD GROUPS / RACES / NATIONSPROBLEMS WITH AUTHORITYOTHEROTHERPLEASE EXPAND:GIFTINGSADMINISTRATIONCOMMUNICATIONSDRAMA/THEATREHEALINGMEDIAPASTORAL CAREPREACHINGPREACHINGART/CREATIVITYCOUNSELINGENCOURAGEMENT HOSPITALITYMEDICALPIONEERPROBLEM SOLVINGWORSHIPCHILDREN’S WORKDISCIPLESHIPEVANGELISMSKILLED TRADESMANMUSICPRAYER/INTERCESSIONSERVANT HEARTEDYOUTH WORKOTHERIN YOUR OPINION, IN WHICH OF THE FOLLOWING AREAS OF MINISTRY IN THE APPLICANT GIFTED?OTHERPLEASE EXPAND:CHARACTER PROFILE PLEASE RATE THE FOLLOWING:INITIATIVE12345678910WORK ETHIC12345678910TEAM PLAYER12345678910ABILITY TO HANDLE CONFLICT12345678910MOTIVATED12345678910FINANCIAL RESPONSIBILITY12345678910PERSONAL GROOMING12345678910SOCIAL ADAPTABILITY12345678910SENSITIVE TO OTHERS12345678910SELF LEADERSHIP12345678910ABILITY TO FOLLOW12345678910TEACHABLE12345678910FLEXIBILITY12345678910RELIABILITY12345678910RESPONSE TO AUTHORITY12345678910TIME KEEPING/PUNCTUALITY12345678910PERSEVERANCE12345678910SOUND JUDGEMENT12345678910ATTITUDE TO WORK12345678910LEADERSHIP CAPABILITY12345678910RESILIENCE12345678910PERSONAL ORGANISATION12345678910TRUSTWORTHY12345678910ACADEMIC ABILITY12345678910ACADEMIC ABILITY12345678910MORAL STANDARDS12345678910FAMILY BACKGROUNDPLEASE COMMENT ON THE APPLICANT’S FAMILY BACKGROUND AND CURRENT SITUATION (IF KNOWN)MOTIVESIN YOUR OPINION, WHAT ARE THE APPLICANT’S MOTIVES FOR APPLYING TO JOIN YWAM LIVERPOOL?DO YOU THINK PARTICIPATION IN YWAM WOULD BE BENEFICIAL FOR THE APPLICANT?DO YOU THINK YWAM WOULD BENEFIT FROM THE APPLICANT SERVING WITH US?DO YOU RECOGNISE THAT THIS PERSON HAS A CALLING TO MISSIONS?ADDITIONAL COMMENTSWOULD YOU EMPLOY/WORK WITH THIS PERSON?WHAT PERSONAL EXPERIENCE DO YOU HAVE OF THE VOLUNTEER’S ABILITY TO WORK WITH/RELATE TO CHILDREN AND/OR YOUNG PEOPLE?PLEASE MAKE ANY ADDITIONAL COMMENTS REGARDING THE APPLICANT, WHICH YOU CONSIDER COULD BE HELPFUL.DATA PROTECTIONIN ACCORDANCE WITH UK LAW, THE INFORMATION PROVIDED ON THIS REFERENCE FORM WILL BE HELD SECURELY, CONFIDENTIALLY AND ONLY USED FOR THE PURPOSES NEEDED. I AGREE TO LET YWAM LIVERPOOL KEEP THE INFORMATION PROVIDED FOR THE INTENDED PURPOSES.YesNoWAIVER OF CONFIDENTIALITYUNDER THE DATA PROTECTION ACT, AN INDIVIDUAL HAS THE RIGHT TO REQUEST TO SEE THEIR REFERENCES WITH THE PERMISSION OF THE AUTHOR. WOULD YOU BE WILLING FOR THIS REFERENCE TO BE DISCLOSED TO THE APPLICANT ON REQUEST?YesNoREFEREE’S DETAILSNameAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhoneEmail *ARE YOU FLUENT IN ENGLISH?YesNoPLEASE LIST LANGUAGES SPOKESignatureClear SignatureDate / TimePRINTED NAMESubmit