Spiritual Leader Reference Form

APPLICANT"S NAME:
The person named above has applied to the Professional Association of Christian Counsellors and Psychotherapists to become a member. Your assessment of the applicant"s characteristics will enable PACCP to evaluate whether this applicant meets its standards. Please respond to all questions to the best of your ability.
REFERENCE"S NAME
ADDRESS
TELEPHONE:
EMAIL:
Relationship to Applicant:

Pastor/Priest Elder/Deacon Bishop/District Superintendent
Your highest academic degree earned:

	Excellent	Strong	Good	Weak	Not Observed
Christian Character
Personal Discipline
Practice of Spiritual Disciplines
Engagement Within the Local Church
Ability to Work on a Team
Respect for Constituted Authority
Clear and Concise Statement of Faith in Christ
Ethical Conduct
Relationship Skills
Reputation in the Community
Emotional Health and Stability
Overall Christian Character