Pastor Reference Form

One pastoral reference is required for PRC volunteer applicants seeking to work directly with clients. Pastors, please complete the reference form below or use the links below the form to download it in PDF or Microsoft Word and submit it by mail, email or in-person. If you have any questions, please call (540) 552-5556.

Pastor Reference Form

Please fill out this form, keeping in mind that this information will be used in making a decision about this person’s acceptance as a volunteer. It would be most helpful to us if you could be quite candid in your evaluation. Please know that the individual will not view this form unless you desire to share it with him/her. If you have any questions please feel free to call our Blacksburg office at (540) 552-5556.
Name of Volunteer Applicant
Your Name
Church Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone Please provide the church phone or whichever number at which you prefer to be reached.
Your Email
How long has this person been a member of your church?
Is this person a church member in good standing?
How would you characterize this person's spiritual life?
In what capacity has this person served in the church?
How would you rate this person's interpersonal relationship skills?
ExcellentGoodFairPoor
Does this person tend to become overly committed, starting projects with enthusiasm, but quickly "fizzling out"?
Yes, you described it.No, he/she sticks with projects.
Do you know this person's stand on abortion?
YesNo
If so, how would you describe their belief about abortion?
How would you rate this person on the following: (1 - average, 2 - above average, 3 - excellent)
Dependability
Confidentiality
Cooperation
Compassion
In your best judgment, would this person be better off serving in a role other than one involving direct client contact? (Office work, sorting baby clothes, helping with an event, etc.)
Do you have any other observations or comments that might help us in placing this person?
Would you recommend this person for volunteer service with us?
YesNo
Why/why not?

Verification

I verify that all above information and answers are true to the best of my knowledge. *Your initials serve as your electronic signature in agreement to this statement.

Submit Reference Form

Please enter any two digits *Example: 12
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Or you can download the pastor reference form in PDF or Microsoft Word formats below, then complete and submit by mail, email or in person:

Pastor Reference Form (PDF)

Pastor Reference Form (Word)

Pastor Reference Form

Pastor Reference Form

Verification

Submit Reference Form

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