HSSM1 Pastoral Reference
Thank you for taking the time to fill out a pastoral reference for the applicant. Please submit your reference by May 21, 2023. Also, please know your answers will be kept confidential.

**  If you prefer, you can print this application and mail it to HSSM at 520 South Walnut Casper, WY 82609
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Student's Name *
Your Name *
Phone Number *
Email Address *
Gender *
Required
Address *
City, State, Zip
Do you__________ this student? *
Other comments
How long have you known the applicant? *
In what capacity? *
How well do you know him/her? *
To your knowledge, has the applicant made a personal commitment to Jesus Christ? *
To what extent is the applicant engaged in the activities of your church? *
In what form of Christian service has the applicant participated regularly (Sunday School Teacher, Youth Leader, Nursery Worker, etc.)? *
What do you consider to be the applicant's strengths? *
What do you consider to be the applicant's weaknesses? *
Please describe any physical or emotional conditions, or special attention needed that this person might require.
To your knowledge, does the applicant drink alcohol in excess? *
If yes, please explain:
To your knowledge, does the applicant use tobacco? *
If yes, please explain:
To your knowledge, does the applicant use illegal drugs? *
If yes, please explain:
Please describe home factors which might affect the applicant's success at Hope's School of Supernatural Ministry? *
For the following, rate the applicant on a scale of 1 -10, with 1 being the weakest and 10 being the strongest. Please provide any additional information necessary.
The applicant's influence on his or her peers: *
Other comments
Response to authority *
Other comments
Reliability: dependability, responsibility *
Other comments
Maturity: personal development, ability to cope with life situations *
Other comments
Emotional Stability: reaction to stress, poise, mood stability.
Clear selection
Other comments
Motivation: genuineness and depth of commitment *
Other comments
Judgement: ability to analyze a problem *
Other comments
Oral expression: clarity, coherence *
Other comments
Interpersonal relations: rapport, cooperation, attitudes toward supervision. *
Other comments
Empathy: sensitivity to the needs of others. *
Other comments
Work Habits: stamina, conscientiousness, perseverance, resourcefulness, initiative. *
Other comments
Leadership: creative thought, curiosity, self-confidence. *
Other comments
Personal Appearance: cleanliness, grooming *
Integrity: honesty, moral character *
What characteristics best describe the applicant?
Please add any further comments you may have which would help in our evaluation.
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