Pastoral Reference Form

Pastoral Reference Form
DATE*
Date Format: MM slash DD slash YYYY
FAMILY LAST NAME*
PARENTS FIRST NAME(S)*
STUDENT FIRST NAME(S)*
Dear Pastor, Elder, or Leader in Church, Your name has been given as reference by the parent(s) indicated above who are seeking to enroll their child(ren) at Providence Christian School NW (PCSNW) in Ferndale, WA. We would appreciate your time in answering these questions to the best of your ability. If you are unable to answer some questions, please share this in the comment boxes. The answers will be held confidential.
Do you personally know the family?*
- YES
- NO
How well do you know the family?*
How long have you known the family for?*
It is good to know if the parent(s) and child(ren) attend worship services regularly - can you speak to their attendance?*
Are the parents active in church and other activities?*
- YES
- NO
Please specify*
Is the student active in church activities?*
- YES
- NO
Please specify*
Church*
Phone Number*
Address*
Signature*
Position*

Providence Christian School NW