Pastoral Reference "*" indicates required fields Applicant's Name* First Last Pastor's Name* First Last Pastor's Email* Pastor's Phone*(a) How long have you known the applicant?* (b) How long has the applicant attended this church?* (c) How well do you know the applicant?*(d) Has the applicant been born again of the water and the Spirit?*YesNo(e) Does the applicant live a holy and separated lifestyle, according to the Word of God?*YesNo(f) Is the applicant faithful in tithing, generosity, and serving the local church?*YesNo(g) Have you had to deal with any problems or issues as a direct result of the applicant's counseling methods?*YesNo(g) Please Explain*(h) Do you have any spiritual concerns regarding this applicant and their service to the Center for Apostolic Counseling?*YesNo(h) Please Explain*(i) Do you have any concerns regarding the character of this applicant?*YesNo(i) Please Explain*(j) Have you referred individuals to this applicant for counseling?*YesNo(k) Overall, would you recommend the applicant?*YesNoOther CommentsPastoral Signature* By checking this box, I am acknowledging that all information I provided is accurate to the best of my knowledge. PhoneThis field is for validation purposes and should be left unchanged.