Lake Brownwood Christian Retreat
9030 Retreat Road Brownwood, Texas 76801
(325) 784-5133
lbcr@
Applicant Reference Form
Please complete the following questions to the best of your ability and provide as much information as possible.
Candidate name ____________________________________ Years known _________
Your name ________________________________________ Phone # _______________________
1. What is your relationship to the applicant?
____Employer or Supervisor ____Pastor ____Teacher ____Roommate
2. In What Situations Have You Observed the Applicant?
____Home ____Work ____School ____Social ____Church ____Other
3. What can you tell us about this applicant?
4. What could we do to aid in the applicant's personal development?
5. Give your personal impression of the applicant's spiritual life (devotions, prayer, witness etc.).
6. Has the applicant proven on any occasion to be unreliable, dishonest, or of questionable character?
Character
Please rate the applicant on a scale of 1-5 with one being the worst and 5 being the best
Dependable ____ Fair ____ Optimistic ____ Kind ____ Encouraging ____ Humble ____
Helpful ____ Lazy ____ Dishonest ____ Vulgar ____ Adaptable ____ Compassionate ____ Energetic
Efficient ____ Extraordinary ____ Flexible ____ Honest ____ Independent ____ Mature ____ Reliable ____
Personal
Please rate the applicant on a scale of 1-5 with one being the worst and 5 being the best
Personal appearance ____ Receives constructive criticism ____ Christian Character ____
Concern for others ____ Social Skills ____ Integrity ____ Decision making ____ Ability to follow ____
Work etchic
Please place an X next to the appropriate category
Team player: Often ____ Seldom ____Sometimes ____ Never ____ Not Observed ____
Works well with others as part of a team: Often ____ Seldom ____ Sometimes ____ Never Not Observed ____
Observance of deadlines: Often ____ Seldom ____ Sometimes ____ Never Not Observed ____
Ability to take initiative: Often ____ Seldom ____ Sometimes ____ Never Not Observed ____
Punctuality: Often ____ Seldom ____ Sometimes ____ Never ____ Not Observed ____
Reference forms may be mailed to:
Attn: Executive Director
9030 Retreat Road
Brownwood, TX 76801
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