Dear Pastor or Mentor,

It is an honor to serve alongside you and to reach millions of souls together for Jesus! At Compassion to Action, we have a passion not just to do large events but to see disciples made. In one of our recent vision casts for Portland: 2018, I gave the challenge to see a minimum of 1500 people commit to becoming a Disciple-Maker.  

You are here because someone in your church or congregation has responded to the challenge and applied to be a Disciple-Maker. They have listed you as a reference for their Pastoral Recommendation. We ask that you fill out the following survey so that we can get to know our applicant better. It shouldn’t take longer than four minutes. 

We ask that you would be honest and assure you that nothing you mention will be disclosed. 

Full Name of Applicant *
Full Name of Applicant
How well do you know him/her? Please check one
To your knowledge, has the applicant made a personal commitment to Jesus Christ?
To what extent is the applicant engaged in the activities of your church? Please check one of the following
Which characteristics best describe the applicant? Please check all that apply.
The applicant’s influence on his or her peers is