Pastor Reference Form 
Instructions:

AttaKid! is a Christ-Centered mentor program involved with children and families “at risk.” The below named individual is being considered for involvement with an at-risk child in a mentoring relationship. Due to the difficult nature of working with at-risk children, we need a candid recommendation from you as their pastor. To help us determine whether this person is best suited for this type of volunteer work, we would appreciate you taking the time to answer the questions on this form as fully and specifically as you can. Please be assured that this will be kept in confidence. Thank you.
Email *
AttaKid!
Your Name *
Church Name *
Phone Number *
Email *
Name of Mentor Applicant *
How long have you known the applicant? *
In what capacity?
*
Does the applicant have a good home relationship?
*
Does he/she work well with others?
*
Please comment on his/her level of commitment.
 *
Does he/she have a tendency to over-commit himself/herself?
*
How would you rate him/her according to the following: Personal Habits
 *
Poor
Excellent
How would you rate him/her according to the following: Character
 *
Poor
Excellent
How would you rate him/her according to the following: Compassion for those in need
 *
Poor
Excellent
How would you rate him/her according to the following: Morals
 *
Poor
Excellent
How would you rate him/her according to the following: Responsibility to complete commitments
 *
Poor
Excellent
How would you rate him/her according to the following: Emotional stability
 *
Poor
Excellent
How would you rate him/her according to the following: Christian maturity    
 *
Poor
Excellent
How would you rate him/her according to the following: Receives constructive criticism  
 *
Poor
Excellent
How would you rate him/her according to the following: Personal Health
 *
Poor
Excellent
If you were in our position, would you, without hesitation, consider this person to be a volunteer in this capacity?
 *
Is there any reason why you would not recommend this applicant for working with a child?
If yes, please explain.
*
To your knowledge, has the applicant ever been arrested, yes or no? Please comment.
 *
To your knowledge, has the applicant ever been accused or convicted of child abuse, yes or no? Please comment.
 *
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