Intern Pastoral Reference

Intern Pastoral Reference
Name of Applicant *

First NameLast Name
Your first and Last Name:*
Your Church name and Your position*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Relationship to applicant *
How long have you known the applicant, and in what capacity?*
Please assess the applicant's level of involvement in your church*

Attends regularlyAttends irregularlyEnthusiasticCooperativeInvolvedWilling to helpInterestedDistant
Has the applicant served your congregation in any capacity? If so, please give a brief description.
What are the strengths and spiritual gifts of the applicant, according to your observations?*
What is your assessment of the applicant's weaknesses/struggles? *
What is the applicant’s affect on his/her peers?*

PositiveNegativeNeutralUnknown

Please try to assess the following based on your knowledge of the applicant. *

Comments on any of the above:
Are there any family or relational factors which might affect the applicant's service in the House of Prayer Internship? *
The internship consists of a 15-20 hour weekly schedule. Do you foresee any difficulties in the response of the applicants to this type of schedule? *
Would you have the applicant on your staff? Yes or no, and why or why not?*
Recommendation of this applicant for the House of Prayer Internship:*

Highly recommendRecommendRecommend with reservationsDo NOT recommend
Any additional comments or concerns that you feel we should know?
If we have any questions or concerns, may we contact you by either email or phone?*

YesNo
Should be Empty: