Referral Form

*Print first and then fill out.  Make sure to use the printer friendly version when you print. Find this option at the bottom of the page.  Please mail to The REAP Team office upon completion.  Our Fall application deadline is July 15.  The Winter deadline is December 5.

Applicant's Information

Name___________________________________________

Phone____________________

The following is to be completed by the Referent only:

Thank you for taking the time to fill out this letter of reference for the Catholic youth retreat ministry of the REAP (Retreat Evangelization and Prayer) Team. We greatly value the information that we receive in these referrals and use them as an important source in determining whether or not someone should be accepted to our ministry. Because our volunteers serve in positions of spiritual leadership for young people, we accept only those applicants who show exemplary Christian character and who possess the skills necessary for successfully leading youth to Christ. Your honest and straightforward appraisal of the applicant's strengths and weaknesses will help to insure the fielding of the finest possible team members during the coming year. You may rest assured that everything in this form will be held as strictly confidential. Thank you!

Referent's Information

Name___________________________________________

Permanent Address______________________ City_________________ State____ Zip________

Home Phone____________________ Work Phone____________________

If needed, I may be contacted at ____home ____work ____either.

Please completed the following sentence:
I am presently [Under 20 20-24 25-29 30-39 40-49 50+] years of age. (please circle one)

About the Applicant

Please answer the following questions in the space provided. If you need more space, feel free to use another page.

1. How long have you known the applicant, and in what kind of relationship?

2. How well would you say you know the applicant?
____very well ____well ____average ____not well ____very little

3. How does the applicant respond to authority?

4. Can the applicant take responsibility and demonstrate leadership?

5. Are you aware of any instances of mental or emotional illness which the applicant or members of the applicant's family have had?
____Yes ____No (If yes, please explain.)

6. Do you have any reason to question the applicant's moral character?
____Yes ____No (If yes, please explain.)

7. Are you aware of any outstanding gifts or abilities in the applicant?

8. What degree of confidence would you give this applicant in:
a) One-on-one ministry: (low) 1 2 3 4 5 (high)
b) leadership position: (low) 1 2 3 4 5 (high)
Please comment:

9. Using the scale below, please rate the applicant on the following:

In the event that an opportunity to comment on some important information about the applicant has not been given, please use the space below or another page to include your remarks.

Thank you for taking the time to complete this reference letter for The REAP Team. I am very grateful for your assistance.

Please mail the completed form to the REAP Team Office by July 15 or December 5:

The REAP Team
27 Grand Circle Drive
Maryland Heights, MO 63043

Phone: 314.298.9597