Pastoral Reference Form

Pastoral Reference Form

The individual who sent you this link is completing an application to attend Canadian Baptist Bible College. Please answer the following questions as accurately as possible to assist in the application process.
Date*

MonthDayYear
Full Name of Applicant*

First NameLast Name
Full Name of Reference*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Cell Phone

Area CodePhone Number
1. How long have you known the applicant?*
2. Are you related to the applicant in any other way besides being the applicants Pastor? (i.e., parent, brother, sister, employer, etc.)

YesNo
If yes, how?
3. To your knowledge, is the applicant a born-again Christian?*

YesNoDon't know
If yes, when?
4. Does the applicant's daily life give evidence of spiritual growth? Please comment.*
5. To your knowledge, are the applicant's parent(s)/ guardian(s) born-again Christians?*

YesNoDon't know
If yes, when?
6. In what ways has the applicant been involved in church and/or youth activities?*
7. Please describe the applicant's home-life*
(Include information about the spiritual and moral leadership of the parent(s) relationships among family members and relationships of applicant to parents.)
8. With what kind of friends does the applicant associate?*
9. How is the applicant influenced by his/her peers?*
10. Please list any skills, talents, personality and character strengths you have observed.*
11. Please note any personality or character weaknesses you have observed.*
12. Have you had occasion to question the applicant’s morals?*

YesNo
If yes, please explain.
13. How does the applicant respond to authority and discipline at home, church and school?*

14. Does the applicant participate in any of the following:*

	Habitual	Selective	None	Unknown
Use of Alcohol
Use of Tobacco
Use of Drugs (non-medicinal)
Pornography
Occult Activities

Comments on above
15. Do you see potential for future Christian ministry as:

Lay workerPastorMissionaryOther
16. Acceptance by Others

Highly respectedWell acceptedPoorly acceptedCannot report
17. Attitude Toward Work

EnthusiasticGenerally positiveBelow potentialUsually negativeCannot report
18. Attitude Toward Peers

Relates very wellUsually relates wellSome difficulty in relatingReluctant to interactCannot report
19. Concern for Others

Genuinely concernedModerately concernedSomewhat concernedIndifferentCannot report
20. Emotional Stability

Consistently well-balancedUsually well-balancedSubject to mood swingsUnstableCannot report
21. Industry

Does more than assigned workDoes only assigned workNeeds occasional proddingWorks only under compulsionFails to do required work
22. Integrity

Consistently trustworthyGenerally honestQuestionable at timesNot dependableCannot report
23. Leadership

Organizes and directs othersOccasionally leads othersSomewhat dependentFollowerCannot report
24. Motivation

Highly-motivatedUsually motivatedSomewhat motivatedLacks motivationCannot report
25. Responsibility

Totally responsibleUsually responsibleSometimes responsibleNot dependableCannot report
26. Social Skills

Good social skillsAverage social skillsBelow averageLacking social skillsCannot report
27. Teachability

OutstandingReadily teachableSlow but retains wellNeeds repeated instructionCannot report
15. If accepted, in what areas might the applicant need help or guidance?*
16. Do you recommend that we accept this applicant?*

YesNoWith ReservationUnsure
If other than yes, please explain:
17. Please provide any additional information that could help in the application process.
Signature*

Clear
Should be Empty: