PASTORAL REFERENCE FORM

INSTRUCTIONS FOR PASTOR: In order for us to provide a safe atmosphere for our campers, it is important that we know if a person applying for employment for to volunteer at Camp Challenge is an appropriate candidate to work with children. It is essential that you give us an accurate evaluation. Any comments that you make will be kept in confidence by Camp Challenge staff.

Pastor Information

Name: *

Title: *

Email: *

Church Name: *

Church City: *

Denomination/Affiliation: *

Applicant Information

Applicant First Name *

Applicant Last Name *

Is the applicant a member of your immediate family? *

Yes
No

Is the applicant currently involved with your church on a regular basis? *

Yes
No

Does this person demonstrate Christ-like values in her/her life? *

Yes
No

Do you have any reservations about this person serving at camp? *

I do not have any reservations
I have reservations
I do not know this person well enough to make an evaluation

Please elaborate:

Do you feel the applicant is better-suited for a leadership role or a supporting role; for example, head counselor or co-counselor? *

Leadership
Support
Other

If you selected other, please explain:

Would you like the camp director to call you about this person? *

Yes
No

Preferred Phone Number

Timeout Warning

PASTORAL REFERENCE FORM

Pastor Information

Applicant Information