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About CAC
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Pastoral Referral
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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?
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Yes
No
Does the applicant live a holy and separated lifestyle, according to the Word of God?
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Yes
No
Is the applicant faithful in tithing, generosity, and serving the local church?
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Yes
No
Have you had to deal with any problems or issues as a direct result of the applicant's counseling methods?
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Yes
No
Do you have any spiritual concerns regarding this applicant and their service to The Center for Apostolic Counseling?
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Yes
No
Do you have any concerns regarding the character of this applicant?
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Yes
No
Have you referred individuals to this applicant for counseling?
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Yes
No
Overall, would you recommend the applicant?
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Yes
No
Other Comments
PASTORAL SIGNATURE
*
By checking this box, I am acknowledging that all information I provided is accurate to the best of my knowledge.