Church Reference

Prospective Student Information

Applicant's Name: *

Referrer Information

First Name: *

Last Name: *

Position: *

Church Name: *

Address Line 1:

Address Line 2:

City: *

State: *

Zip Code: *

Email Address: *

Day Phone: *

Regarding the Prospective Student

Please indicate how long and in what capacity have you known this applicant: *

Please rate the applicant for each of the following characteristics:

Character and Emotional Maturity: *

Level of Applicant's Congregational Involvement: *

Depth of Applicant's Awareness and Discernment of Faith Issues: *

Potential for Service and Leadership in the Church: *

Please provide a brief statement of strengths the applicant would bring to a degree program: *

Please provide a brief statement of anything that might prove difficult for the applicant related to a degree program: *

Overall Recommendation of the Applicant: *

Additional comments that may be helpful to the admissions committee:

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