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Graduate School of Theology
1211 South Glenstone Avenue
Springfield, MO 65804 USA
Fax: 417-862-0863
REFERENCE FORM
PASTOR/CHURCH LEADER
Name of applicant
Address of applicant
I have given your name as a reference in an application for
admission to the Graduate School of Theology of Global
University to pursue a Graduate Studies Certificate program
or an MA, MDiv, or DMin degree program. Please complete
this form and mail it to the address shown above.
NOTICE TO THE APPLICANT: In the United States, PUBLIC LAW 93-380, the
Family Education Rights and Privacy Act of 1974, grants all students the right to
inspect and review all of their official records. This right extends to letters of
recommendation, except that a student may waive his/her right to inspect and review
letters of recommendation by signing a waiver.
I have waived my right to see this and other recommendations.
I do not waive my right to see this and other recommendations.
Signature of Applicant
Applicant’s failure to sign indicates right to see this recommendation is not waived.
We, of the Graduate School of Theology of Global University, appreciate your honest estimate of the ability of this applicant to undertake a Master of
Arts, Master of Divinity, or Doctor of Ministry degree program. Thank you for your assistance by responding to the following questions and surveys.
How long have you known applicant? In what relationship(s) (circle) Pastor, Teacher, Employer, Advisor (Other)
Please rate applicant by checking all items that apply for each heading
below. Do not check items in areas about which you feel uncertain or
that you have had no opportunity to observe.
Intelligence
Thinks logically
Learns and thinks slowly
Has average mental ability
Is alert or inquisitive
Learns and thinks rapidly
Teachability
Rigid, argumentative
Very opinionated
Open minded
Willing to receive instruction
Perseverance in completing tasks
Gives up easily or is easily discouraged
Needs encouragement to persevere
Persists in most circumstances
Achievement (formulates, executes, and carries plans to
conclusion)
Does only what is assigned
Starts but does not finish
Is innovative
Is resourceful and effective
Has superior creative ability
Self-discipline
Leaves everything until the last minute
Is not very disciplined, but responds to deadlines well
Is self-disciplined, plans and works ahead of schedule
Please check any traits in the list below that you have noted in applicant.
Aloof
Anxious
Argumentative
Arrogant
Critical of others
Depressed
Discouraged
Domineering
Easily embarrassed
Easily offended
Frequently worried
Impatient
Inability to take a joke
Intolerant
Irritable
Lacking tact
Nervous
Prejudiced toward groups, races, or nationalities
Quick-tempered
Rigid, not adaptable
Rude
Self-centered
Sullen
Unteachable
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Do you have reason to doubt or question the applicant’s personal
integrity? If so, explain:
Do you have any reservations about recommending this person? If so,
please explain.
You may write additional facts you feel we should know on a separate
sheet. You also may include additional references you feel are qualified
to help in evaluating this applicant.
Signature
Date
Based on your knowledge of the applicant, how would you rate his or her
potential success in a Master of Arts, Master of Divinity, or Doctor of
Ministry program? (Circle the highest level you feel student could achieve.)
Exceptional Very good Good Fair Poor
Comment:
What do you believe is the applicant’s motive in applying to Global
University’s Graduate School?
Name (please print)
Position or title
Address