Lit Personal Reference Form (Page 2 of 2) in pdf

Please “Underline” all statements which you KNOW to be true about the applicant. Feel free to add

statements if the ones listed do not adequately describe their characteristics

Christian Testimony: effective; depends on people he/she is with; weak; has no testimony; enjoys sharing testimony; find

it difficult to share their testimony.

Spiritual Life:

steady and growing; up and down; an inspiration to others; leans on friends; victorious; lacks victory;

studies the Bible; reads the Bible occasionally; tries to apply Bible principles.

Christian Character: the following fruits of the spirit are evident in his/her relationships with people: love; joy; peace;

patience; kindness; goodness; faithfulness; gentleness; self-control.

Church Life:

attends regularly; attends irregularly; tithes regularly; actively involved; limited involvement; not

involved; been away for a while but has kept good contact; been away for a while and has not kept

very good contact.

Home Life:

loves family; contributes to family’s well being; has no family; wishes was in a different family;

respects parents; parents are Christians; is in a right relationship with parents/siblings; family

relations need work.

Social Life:

friendly; a loner; needs considerable privacy; outgoing; shy; leans on others; has many friends; has a

few friends; gets along well with others; has difficulty making friends.

Emotional Stability: stable; irritable; anxious; peaceful; easily discouraged; occasional depression; difficulty controlling

temper; controls emotions; on medication to control emotions; moody.

Personality:

introvert; extrovert; optimist; pessimist; creative; initiator; aggressive; easygoing; critical;

encourager; good sense of humour; well disciplined; poor personal discipline; submissive to authority;

co-operative; manipulative; easily intimidated.

Work Habit:

enjoys work; procrastinates; completes assignments; lazy; let others do it whenever possible;

follows instructions carefully; ignores instructions; sloppy; perfectionist; does just enough to get

by; takes pride in work; on time, often late; a quitter; rarely gives up; dependable; responsible;

prefers to work alone.

With Peers

Leadership Ability:

: a follower; a pace setter; accepts responsibility when asked

With Children

: exceptional; comes naturally; enjoys leading children;

has never tried but would like the opportunity; afraid of children.

Health

Physical Condition:

: rugged; average; tires quickly; frequent colds; on medication; health problems; allergies;

disabilities; athletic; physically fit.

Appearance

: meticulous; pleasant; average; sloppy; neat.

The Outdoors:

enjoys it; avoids it; what is it?; would like to learn more; like tenting; hates dirt; likes water.

Additional Comments: __________________________________________________________________________

___________________________________________________________________________________________

DO NOT RETURN TO APPLICANT Mail Directly to: Circle Square Ranch

Box 610 Wolseley, SK

S0G 5H0

ATTN: Robin Exner, Director (306) 698-2662

Lit Personal Reference Form Page 2

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