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Scholarship References
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Scholarship References
DHM Scholarship Reference Form
Date
*
Reference for (applicant name):
*
Demonstrates creativity:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Please provide a short paragraph (no more than 150 words) describing the applicant's potential for ministry:
*
Demonstrates initiative:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Takes personal responsibility:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Shows sound judgment:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Has realistic goals:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Demonstrates motivation toward goals:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Logic and clarity:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
General character:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Comments regarding applicant's personal and character skills:
Interacts well with others:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Is respectful to others:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Receives respect from others:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Demonstrates leadership abilities:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
General relational skills:
*
4 - Excellent
3 - Good
2 - Adequate
1 - Needs improvement
Comments regarding applicant's relational skills:
Relationship to applicant: (PLEASE choose the option for the category for which YOU are filling out the reference form)
*
Pastor of Congregation
Professor
Regional Minister or Chair of Commission on Ministry
Region
*
General Commission on Ministry (GCOM)
Christian Church in Alabama and Northwest Florida
Christian Church in Arizona
Christian Church of Northern California-Nevada
Christian Church of the Pacific Southwest
Christian Church in Canada
Central Rocky Mountain Region
Christian Church in Florida
Christian Church in Georgia
The Great River Region
Christian Church South Idaho
Christian Church in Illinois and Wisconsin
Christian Church in Indiana
Christian Church in the Upper Midwest
Christian Church in Kansas
Christian Church of Greater Kansas City
Christian Church in Kentucky
Christian Church Michigan
Christian Church of Mid-America
Christian Church in Nebraska
Christian Church - Northeastern Region
Christian Church - Northern Lights Region
Christian Church in North Carolina
Christian Church in Ohio
Christian Church in Oklahoma
Christian Church in Oregon
Christian Church in Pennsylvania
Christian Church in South Carolina
Christian Church in Tennessee
Christian Church in the Southwest
The Christian Church in Virginia
Christian Church Capital Area
Christian Church in West Virginia
Chaplains Office
Is this student under the care of your region?
*
Yes
No
If no, is this student in the process of coming under the care of your region?
*
How long has this student been a member of your church?
*
Has this person been a student in a class you've taught?
*
Yes
No
Your name:
*
Address:
*
City:
*
Country:
*
Abkhazia
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Ascension
Ashmore and Cartier Islands
Australia
Australian Antarctic Territory
Austria
Azerbaijan
Bahamas
Bahrain
Baker Island
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Antarctic Territory
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Clipperton Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (DRC)
Cook Islands
Coral Sea Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Islas Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Howland Island
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jarvis Island
Jersey
Johnston Atoll
Jordan
Kazakhstan
Kenya
Kingman Reef
Kiribati
Korea (North Korea)
Korea (South Korea)
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Midway Islands
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Nagorno-Karabakh
Namibia
Nauru
Navassa Island
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Cyprus
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territories (Gaza Strip and West Bank)
Palmyra Atoll
Panama
Papua New Guinea
Paraguay
Peru
Peter I Island
Philippines
Pitcairn Islands
Poland
Portugal
Pridnestrovie (Transnistria)
Puerto Rico
Qatar
Queen Maud Land
Reunion
Romania
Ross Dependency
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Georgia and the South Sandwich Islands
South Ossetia
Spain
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste (East Timor)
Togo
Tokelau
Tonga
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wake Island
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
State/Province
Alabama
Alaska
Alberta
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Labrador
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
Newfoundland
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
North West Territory
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewen
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Yukon
Postal code:
*
Email
*
Phone
*
Δ
Scholarships
Christian Vocation Scholarships Application
Christian Vocation Continuing Education
Commissioned Clergy
Continuing Education Application
Ordained Clergy
Regional Endorsement Form
Scholarship Guidelines
Scholarship References
African American Scholarships
Scholarships Chaplains
Scholarships Choi
Scholarships Jackson
Scholarships Kagiwada
Scholarships Mattison
Scholarships Michael
Scholarships Nebraska Legacy Fund
Scholarships Philputt
Scholarships Rowley Wolfe
Scholarships Schutze
Scholarships Star Supporter
Scholarships Winter Haven Scholarship Fund
Contact Information
Warren Lynn
Executive Minister for Christian Vocations
(317) 713-2652
Kelly Harris
Ministry Associate
(317) 713-2666