Pastoral Referral

Pastoral Reference

First Name of Applicant

Last Name of Applicant

First Name of Pastor

Last Name of Pastor

Pastor's Email

Pastor's Phone

How long have you know the applicant?

How long has the applicant attended this church?

How well do you know the applicant?

Has the applicant been born again of water and the Spirit?

Does the applicant live a holy and separated lifestyle, according to the Word of God?

Is the applicant faithful in tithing, generosity, and serving the local church?

Have you had to deal with any problems or issues as a direct result of the applicant's counseling methods?

Do you have any spiritual concerns regarding this applicant and their service to The Center for Apostolic Counseling?

Do you have any concerns regarding the character of this applicant?

Have you referred individuals to this applicant for counseling?

Overall, would you recommend the applicant?

Other Comments

PASTORAL SIGNATURE

By checking this box, I am acknowledging that all information I provided is accurate to the best of my knowledge.