Breakout! Missions Teams
Recommendations Form

Name of applicant: __________________________________________

How long have you known them? ______________________________

Based on the following, how would rate the applicant?
1 = poor  2 = acceptable  3 = average  4 = very good  5 = outstanding

Positive attitude  1  2  3  4  5
Teachable spirit  1  2  3  4  5
Abilitiy to communicate 1  2  3  4  5
Servant heart 1  2  3  4  5
Trustworthyness/reliability 1  2  3  4  5
Willingness to receive correction 1  2  3  4  5
Ability to deal with conflict 1  2  3  4  5
Ability to work in a team 1  2  3  4  5
Emotional stability 1  2  3  4  5
Relationship with God 1  2  3  4  5

Any other comments:














On the basis of your knowledge of the applicant, please indicate which of the following is most applicable:

Highly recommended, no reservations whatsoever.
Recommended with confidence.
Recommended with some reservation.
Not recommended.


Signature: ____________________________  Date: _________________

Please send to: Stewart Bloor, PO BOX 1216, Dudley. DY3 1GW.