Pastoral Reference Form

Before Beginning

TO THE PASTOR COMPLETING THIS FORM: You need to be over 21 years old, cannot be a relative, and must have known the applicant for at least one year. If you are the parent and pastor of the applicant, the youth pastor, elder or a leader in the church will be accepted. Please answer the following questions carefully.

General Information

Name of Applicant (required)

Your First Name (required)

Your Last Name (required)

Email Address (required)

Phone Number (required)

How long have you known the applicant?

How well do you know him/her?
Just by name and sightCasually - have had a few contactsFairly well - have had a number of personal contactsHave had a very close pastor-young person relationship

As far as you know, has s(he) been born again by faith in Jesus Christ?
YesNo

Comments:

To what extent has the applicant engaged in the activities of your church?
Very irregular in attendance; little interest in activitiesSeldom participates in activities; does regularly attendIs cooperative & usually willing to help in various activitiesEnthusiastically engages in activities of the church

In what forms of Christian Service has the applicant been regularly active? (Sunday School, Choir, Children’s Church, etc.)

If applicant doesn’t participate, do you know why?

Does s(he) come from a Christian home? a well-disciplined home? receive encouragement at home?

Is s(he) inclined to receive instruction? yield to discipline?

Does s(he) have any special talents or abilities? (Please list)

Have you noted any particular weaknesses? (Please list)

Have you observed anything that would be questionable about his/her moral life? If so, explain:

Have you ever known the applicant to use intoxicating beverages? tobacco? drugs? If so, explain:

If you were a member of the Admissions Committee at Frontier, would you vote to accept him/her as a student?
EnthusiasticallyWillinglyQuestionablyNot at all

Personality and Character Assessment

Check the rating that indicates your estimate. Additional remarks for fuller explanation will be most helpful to us.

Spiritual Life

Vital & ContagiousRich & Growing in MaturityAverageGenuine, but not ContagiousCharacterized by Immaturity
Additional Comments:

Purposefulness

Well-formed PurposeSelf-directedAverageVacillating in PurposeAimless Drifter
Additional Comments:

Initiative

Anticipates Needs: ResourcefulShows Good InitiativeAverage – Occasional InitiativeRequires Some DirectionRequires Constant Supervision
Additional Comments:

Cooperation

Works Well With OthersWorks Well Under OthersCooperative Only Under PressureNot Cooperative
Additional Comments:

Judgment

DiscerningGood Common SenseAveragePoor Sense of Values
Additional Comments:

Tactfulness

Very Sensitive to OthersUsually CourteousSometimes UntactfulBlunt, OutspokenInsensitive to Others
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Responsibility

Capable of Much ResponsibilityThoroughly DependableUsually ReliableShows Some DependabilityIrresponsible, Careless
Additional Comments:

Industry

Seeks Additional WorkGoes Beyond What Is RequiredCooperativePerforms Assigned TasksNeeds ProddingDifficult to Handle
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Intelligence

Very SuperiorAlert (Above Average)AverageBelow AverageDull
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Acceptance By Others

Sought After By OthersWell Liked By OthersLiked By OthersJust Tolerated By OthersAvoided By Others
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Leadership

Inspiring and Successful LeaderGood LeadershipAssumes Occasional LeadershipTries, But Usually Fails at LeadershipAlways a Follower
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Emotional Stability

Exceptionally StableWell BalancedUnresponsiveHigh Strung, but ControlledExcitable-Easily Upset
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Personal Appearance

Neat AppearanceAverage AppearanceCareless in Dress
Additional Comments:

Financial Integrity

Budgets Wisely – Avoids DebtPays Bills on TimeNeeds Reminders About BillsCareless With Finances
Additional Comments:

Your Electronic Signature

Please Print Your Name Below