Pastor's Recommendation Form

Thank you for helping us complete the admissions decision process by providing this reference. We value your comments and request that you give a full and candid report so that fair consideration may be given to the applicant. If you feel that you do not know the student well enough to give a complete reference, please refer the student to another person.

As a Christian university, we see ourselves as an extension of the mission and work of the local church, preparing leaders and workers to serve in significant ways in a local congregation. Consequently, we rely heavily on you to help us distinguish between those students who are spiritually, socially, and emotionally mature enough to find success here, and those who are not. Our goal is that each student grows in knowledge, Christian maturity, faith, integrity and quality of relationships as a result of their time at North Central.

Your Contact Information

Your Name: *

Name of Church and Denomination: *

Position: *

Church Telephone: *

Church Address: *

City: *

State: *

Zip: *

Date: *

Applicant Information

Applicant's First Name: *

Applicant's Last Name: *

Applicant City: *

Applicant State: *

How long have you known the applicant?: *

To your knowledge has the applicant made a personal commitment to Jesus Christ?: *

Yes

I don't know

How well do you know the applicant?: *

Very Close

Fairly Well

Casually

By name/sight

To what extent is the applicant engaged in the activities of your church?: *

Enthusiastic

Cooperative

Seldom participates

Attends irregularly

What is the applicant's spiritual influence on their peers?: *

Evangelistic

Positive

Neutral

Negative

In what form of Christian service has the applicant participated regularly?: *

How do you rate this person in the following areas?

Applicant ratings: *

	Excellent	Above average	Average	Below average	No chance to observe
Academic Ability
Anticipated Achievement in College
Communication Skills
Cooperativeness
Emotional Stability
Initiative and Motivation
Integrity and Honesty
Leadership
Responsibility
Social Adaptability

To your knowledge, has the applicant used the following in the past year

Alcoholic beverages?: *

Yes

Tobacco?: *

Yes

Non-medical drugs?: *

Yes

Additional comments:

Would you like us to call you to discuss this student?: *

Yes

If necessary

Final Recommendation

Recommendation: *

I recommend this applicant

I recommend this applicant with reservation

I do not recommend this applicant