Instructions:

All of the required fields are marked with an asterisk (*).  You may print the form before you submit it and there is a button at the bottom for this purpose.  If you forget to complete a mandatory field or enter improperly formatted information you will be returned to the form after you submit it.  You will not lose any information during this process.  In the rare event that something happens during your application you can mail the completed online form to Seminary Admissions but please sign it at the bottom.

Pastoral Reference

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Information about the seminary applicant:
Please provide the following information about the person that is requesting the reference, including at least their first name, last name, and e-mail address.  please use the same e-mail address from which they sent you this request. important:  by submitting this reference you agree that grace theological seminary will not share the information with the applicant without your express permission.  if you desire to share this reference with the seminary applicant please print a copy using the button at the bottom provided for this purpose.
*Applicant's First Name
*Applicant Last Name
Applicant Middle Name (optional)
*Applicant's E-mail Address
*Applicant Phone Number	Format xxx-555-1212
Applicant Address (optional)
Applicant City (optional)
Applicant State (optional)
Information about yourself:	NOTE: This reference must be received before the student's application will be evaluated.
*First Name
Middle Name
*Last Name
*Address
*City
*State	Select One Alberta Alabama Alaska Arizona Arkansas British Columbia California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Manitoba Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana New Brunswick Nebraska Newfoundland and Labrador Nevada New Hampshire New Jersey New Mexico Nova Scotia Northwest Territories Nunavut New York North Carolina North Dakota Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island South Carolina South Dakota Saskatchewan Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon -- Other --
*Zip
*Title or Position
Church Name
Phone
*I have known the applicant for approximately how many years?	Number
*Please select your level of familiarity with the applicant (hold down the shift key to select more than one value):	Select One I have had only casual contact with the applicant I have known the applicant well I have observed the applicant's service in church
Please enter any comments about how you know the applicant (255 character maximum):
PLEASE INDICATE YOUR PERCEPTION OF THE APPLICANT:
This information is treated confidentially and is employed in evaluating the applicant. We value your comments and ask that you give a full and candid reports so that fair consideration may be given to the applicant.
Clarity of Goals:
*Demonstrates clear-cut and worthy ministry goals	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Has a clear sense of direction in pursuit of goals.	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Has the support of his/her spouse.	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Industry:
*Demonstrates the effort necessary to achieve goals	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Expends effort and energy wisely	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Ability to Face Reality:
*Foresees problems realistically	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Approaches problems in a constructive manner	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Accepts well-meant criticism and uses it constructively	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Demonstrates openness regarding personal feelings	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Ability to Think Critically:
*Shows insight in identifying problems	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Utilizes resources in solving problems	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Financial Responsibility:
*Shows responsibility in money matters (credit, etc.)	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Interpersonal Relationships:
*Participates willingly and effectively in a group	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Shows leadership ability when the occasion permits	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Relates with others in a meaningful way	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Demonstrates a teachable spirit or attitude	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Initiative and Creativity:
*Reflects originality in approaching problems	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Recognizes and accomplishes necessary tasks	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
General Impressions:
*Generally acceptable in personal appearance	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Socially acceptable in personal habits	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Well accepted by associates	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Possesses a wholesome attitude toward others	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Communication Skills:
*Speaks clearly and effectively	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Expresses ideas clearly in writing	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Interprets accurately and effectively the ideas of others	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
Personal and Intellectual Integrity:
*Accurately appraises strengths and weaknesses	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Pursues goals ethically and conscientiously	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*Represents himself of herself honestly	Select One 1-Poor 2-Average 3-Good 4-Superior 5-Not Sure
*What is your overall evaluation of the applicant (255 characters maximum)?
What potential do you see for effectiveness in ministry (255 character maximum)?
What area(s) do they need improvement? (255 character maximum)
*Please mark the terms that best describes your recommendation of this applicant:	Select One Average High Low Not Recommended Very High
Please indicate if you would like to discuss this further:	Select One No Yes, at the phone # I listed above
Please send me information about the "Partners in Education" matching grant program.  This program matches a church's scholarship funds with seminary grant aid up to a maximum amount per year.	Select One No Yes
Certification and approval
*Approval:	Please select I hereby certify and submit this reference form
*Approval Initials
*Approval Date	xx/yy/20xx
My email address (optional):