RECOMMENDATION FORM

Dear Pastor/Spiritual Leader,

This is to notify you that one of your congregants has applied to travel/serve in missions, internationally, with IMPAC. Kindly complete and submit this form on behalf of the applicant.

Applicant Information:

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Email*

Upcoming Trip date and location: August 7-14, 2021 / Dominican Republic

Pastor/Spiritual Leader Information:

Name*

First Last

Church / Organization:*

Organizational Title:*

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone*

Email*

Website*

1. How long have you know the applicant ?____________________ How well ?*

Very well
Fairly well
Casually
By name/sight

2. Please describe the applicant’s level of involvement at your church. (check all that apply).*

Attends regularly
Attends irregularly
Enthusiastic
Cooperative
Involved
Willing to help
Interested
Distant

3. What are the strengths and spiritual gifts of the applicant according to your observation?*

4. What is your assessment of the applicant’s weaknesses?*

Devotion to Christ*

Integrity and Honesty*

Openness to correction*

Self-Discipline*

Willingness to serve*

Family Life*

Ability to work with others*

Communication skills*

Courtesy*

Leadership Skills*

Reliability*

Physical Health*

Emotional Stability*

Comments on any of the above:*

Signature*

Date*

Applicant Information:

Upcoming Trip date and location: August 7-14, 2021 / Dominican Republic

Pastor/Spiritual Leader Information:

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RECOMMENDATION FORM