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Dunwoody Baptist Church Short Term Mission Reference Form Confidential Reference Form


Thank you for helping Dunwoody Baptist Church and the short-term applicant with the important process of assessing his/her fit for cross-cultural ministry. Your candid and fair responses will help us in this important discernment and assessment process. If you have any questions or concerns, please contact the Missions Ministry at 770.280.1200. Your Name:


Daytime Phone Number:

Name of Applicant:

General Questions We ask that you answer all of the questions. If the question is not applicable, please enter N/A in the space provided. How long have you known the applicant? In what relationship? How do you think this applicant will function in a cross-cultural setting? How would you describe the applicant’s relationship with Christ this past year? Describe how the applicant manages conflict with friends and/or co-workers. Describe the applicant’s ability to take advice and submit to leadership.


Short Term Mission Reference Form Is there any other information which we should consider before reaching a decision concerning this application?

Personal Questions Listed below are a number of personal characteristics. Please select one of the choices listed for each grouping of questions that you feel best describes the applicant. HEALTH

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Frequently ill Fair health Good health Rugged and vigorous Not observed


Group B

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Inconsistent and emotionalistic Occasional lapses Generally stable Constant, maturing, contagious Not observed

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Rarely shares faith, either in a program or individually Only shares faith when part of a program, group, or when expected Takes initiative to share occasionally Regularly looks for opportunities to share faith Not observed


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Little evidence of in-depth biblical study Occasional Bible study Has taken special opportunities for biblical deepening Sound and extensive understanding of biblical truth Not observed


Short Term Mission Reference Form INTERPERSONAL RELATIONSHIPS Group A

Group B

Group C

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Slow to perceive feelings of others Reasonably responsive Understanding and thoughtful Unusually sensitive to the feelings of others; very considerate Not observed

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Easily irritated and offended Occasionally “flies off the handle” Generally patient Almost always copes well with personal frustration Not observed

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Prefers being alone Enjoys both solitude and company Prefers being with others; gregarious Must be with people to be happy Not observed


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Insensitive/inconsiderate Sensitive and considerate, but awkward Overly forward or flirtatious Feels at ease; respectful Not observed


q q q q q

Prefers to work alone Usually cooperative Works well with others Most effective in teamwork Not observed

Revised 01.07.2011