Activ8Her Coordinator Pastoral Reference Form

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Before you may Activ8 your chapter please have your Pastor complete the following Reference form.

Name of Applicant: *

Dear Pastor, We have received an application from the above individual, who would like to be considered as a coordinator for Activ8Her. Would you please complete the attached assessment form? Your response will be confidential. Please return the completed form to: Activ8Her PO Box 1224, Mexico NY 13114 or email to activ8hernow@gmail.com.

How long have you or your associates known the applicant?

In what areas has the applicant served within the church? *

Does she currently serve? If so, in what capacity? *

Yes

Does the applicant reflect a servant’s heart, a love for God, and the family of God? *

Yes

Have you found the applicant to have a teachable spirit? *

Yes

How has the applicant shown that she is able to serve as part of a team? *

Are you aware of any concerns in her life which would impact her ability to serve as a leader within Activ8Her? (ex. Unresolved issues such as: lack of repentance, unforgiveness, impurity, anger) Please elaborate: *

Would you recommend this applicant as a Coordinator for Activ8Her without reservation? Yes/No? (If no, please explain) *

Yes

No (Please explain)

Pastor's Name/Title: *

Church Affiliation and Address:

YYYY

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