Referrals | The Ascent

Name of Applicant that this referral is for*
First Last
Your Name*
First Last
Email*
Phone*
Relation to applicant*
- Pastor
- Employer
- Friend
Evaluation of Applicant
How long have you known the applicant?*
How well do you know the applicant?*
- Name/Sight
- Casual
- Fairly Well
- Very Close

Rank the following on a scale of 1 – 5 by circling that number you believe best describes the applicant. (5 being the highest)*

	1	2	3	4	5
Social Poise
Self Confidence
Adapability
Emotional Stability
Servant Attitude
Ability to communicate clearly
Ability to receive correction
Ability to make decisions
Ability to submit to leadership
Ability to handle stress
Ability to deal with conflict

Is the applicant financially responsible?*
Has the applicant proven on any occasion to be unreliable, dishonest or questionable in character? Please explain*
Do you have any indication that the applicant is applying with The Ascent to escape a difficult situation?*
Describe how the applicant handles authority. To your knowledge has the applicant been involved in anything that we should know about: (Drugs, Alcohol, etc.)*
How would you recommend this person knowing that they represent you?*
- Recommended with the highest assurance
- Recommended with confidence
- Recommended with some reservation
- Not recommended
Anything else you'd like to add?
Today's Date
Date Format: MM slash DD slash YYYY
Signature

Evaluation of Applicant