Pastor's Reference Form

Pastor's Reference Form

Iowa Regular Baptist Camp
This form should be filled out by the pastor or deacon chairman (that is not a relative of the applicant). Your comments play an important role in our hiring process. Thank you for your time and willingness to complete this form for our summer staff application process.
Your Information:
Name*

First NameLast Name
Phone*
E-mail*
example@example.com
Position*
Church Name*
Church Address*

Street Address

Street Address Line 2

CityState

Zip Code
Reference Information
Applicant's Name*

First NameLast Name
Choose One:*

Full Time Summer StaffPart Time Summer Staff (Highschool)
How long have you known the applicant?*
How well do you know the applicant?*
Does the applicant profess to be born again?*
Is the applicant currently a member of your church?*
Is the applicant living a consistent Christian life?*
What evidence of a Christian testimony have you observed?*

Please indicate your observations in the following areas:*

	Outstanding	Good	Needs Improvement	Definite Problem	Not Observed
Leadership Ability
Relationship to the Opposite Sex
Cooperation
Integrity
Ability to get along with others
Faithfulness
Attitude towards Authority
Overall Attitude
Testimony/Reputation

Comments about the above section:
In your opinion, does this person possess any outstanding abilities?*
Does this person have any questionable habits?*
Please comment on the applicant's...
Church Attendance:*
Ministry Involvement:*
Family Background*
To the best of your knowledge, has the applicant ever been involved in, investigated for, or convicted of child molestation, abuse or a felony?*

YesNo
Please comment on any other information IRBC should know that might affect the hiring of this applicant:
I would recommend this applicant to IRBC:*

With EnthusiasmWith ConfidenceWith ReservationNot Recommended
I wish to be contacted regarding this applicant:*

YesNo
Today's Date
Should be Empty:

Your Information: