Pastoral Reference Form

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Please write the first and last name of the individual who is applying. Do not write your own name in this space.

First Name

Last Name

Name of Reference

Phone Number

Email Address

How long and in depth have you known this applicant?

Explain the relationship between you and the applicant.

According to your observation, what are the strengths of the applicant?

What is your assessment of the applicant's weaknesses?

The internship consists of a fairly intense weekly schedule. Do you foresee difficulties for the applicant with this schedule?

Please assess the following based on your knowledge of the applicant:

Devotion to Jesus

Integrity and honesty

Openness to correction

Self-discipline

Working without supervision

Communication skills

Reliability

Emotional Stability

Family Life

Comments on any of the above.

Do you recommend this applicant for an internship?

Please explain.

Additional Comments

Please type your name in the signature box below to confirm your identity and to verify that you have provided a true, correct, and complete character reference.

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