2022 Girls Ministry Leaders - Pastoral Reference
Required for Adults (18 yrs. & Older) Person providing reference may not be related to applicant. Lead Pastor or designated staff pastor or church board member are the only people to fill out this form
Applicant Name - (filled out by designated leader only)
*
First Name
Last Name
I have. been personally acquainted with this applicant for
number
*
years.
Girls Ministry requires the local church to have a current background check on file in church records for all Girls Ministry participants who are 18 years of age or older
In what capacity is applicant currently serving:
*
Limitations/Weaknesses we should be aware of:
Background report and references are on file in church records (required)
*
Yes
No
Trustworthiness
I am personally acquainted with applicant and in my opinion declare that applicat is competent and qualified to work with minors. I have no knowledge of facts or allegations that raise any question concerning his/her suitability and trustworthiness for working with minors.
Non Recommendation
Based on my knowledge of applicant I DO NOT recommend him/her to work with minors.
Additional Comments:
Please Complete:
The person providing reference may not be related to applicant - in that case another staff pastor or church board member may complete the form.
Person Completing Form Name
*
First Name
Last Name
Church Name
*
Your Church position:
*
Lead Pastor
Staff Pastor
Church Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Office Phone
*
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
Email
*
example@example.com
Signature (use cursor or finger)
*
Clear
Date Signed
approval
Approved
Not Approved
Submit
Should be Empty: