CKM Mission Trip Reference Form 

We desire to have mature, committed Christians represent the Lord by serving in short-term missions with Clayton King Ministries. We ask that you complete this form as a true reflection of the applicant as our decision to accept this applicant is based in part on your recommendation. All reference forms will be strictly confidential and only viewed by our Missions Department Staff.

If you have any questions prior to filling out this form, please contact us here:

The applicant will not continue in the application process until this form is received. Thank you! 

Applicant's Name *
Applicant's Name
Name of Reference *
Name of Reference
Address *
Rate the applicant in the following areas *
Please select the top 3 attributes that represent the applicant's strongest traits
I can recommend this applicant *