Pastoral Reference Form

Dear Pastor,

The person named below has applied to join our internship program in Jerusalem. We would be grateful if you would complete this form of reference. Please feel free to contact us with any questions you may have. Thank you very much!

Name of applicant*

First Last

Please specify the person for whom you are providing a reference.

Applicant's email address*

Your Name*

First Last

Your email address*

Name of your church/congregation*

Address of your church/congregation*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone number of your church/congregation*

Email address for your church/congregation

How long have you known the applicant?*

How well do you know the applicant?*

Very Well
Fairly Well
Casually
By Name, Sight

Please describe the applicant’s level of involvement in your church/congregation (check all that apply):*

Attends Regularly
Involved
Enthusiastic
Cooperative
Attends Irregularly

Has the applicant served your congregation in any capacity?*

Yes
No

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?*

Pastoral Reference Form

Step 1 of 2

Dear Pastor,

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