Employers Reference Form Please enable JavaScript in your browser to complete this form.Thank you for your help!A previous employee of the company you represent has submitted an application for ministerial credentials with the Southern New England District of the Assemblies of God. Thank you for taking the time to complete this form. (NOTE: The applicant has signed an Authorization and Release form on file in the district office to release you to confidentially share and waiving their right to see your reference).Applicant's Name *FirstLastCompany NameAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeYour Name *FirstLastYour Position with the CompanyPhoneExtensionYour Email *How long did the applicant work for you?Was the applicant dependable?AlwaysMost of the TimeUsuallySome of the TimeSeldomWas the applicant prompt and regular in work attendance?AlwaysMost of the TimeUsuallySome of the TimeSeldomWhat are / were your observations of the applicant's interaction with other workers?Very FavorableFavorableNeutralUnfavorableVery UnfavorableDon't KnowHow well did the applicant relate to those in authority?Extremely WellVery WellWellPoorlyVery PoorlyPlease check all the words below which you believe best describe the applicant's disposition:Quick TemperedFriendlyMotivatedCongenialTrustworthyStubbornDepressedMild ManneredHardworkingAbrasivePatientQuietCooperativeTalkativeOrganizedDisciplinedWould you, without hesitation, rehire the applicant if he/she applied for work?YesNoAny further comments?SignatureBy typing my name here, I am digitally signing this document, I hereby certify that all statements provided are true and correct.EmailSubmit Reference Form
