Counselor Reference - Pastoral Pastor's Name * Pastor's Name First Name First Name Last Name Last Name Title Counselor's Name * Counselor's Name First Name First Name Last Name Last Name Camp Session(s) Counseling (i.e. Younger Midler, High School 1…) * Church Name & Address * Pastor's Email * Pastor's Phone Number * How often does this individual participate in worship? * Select one optionOnce a monthTwice a monthThree times a monthFour times a month Does this person participate in other ministries or activities? * Select one optionYesNo If yes, please list: How long have you known this person? * Are you comfortable knowing this person will facilitate spiritual growth of students in the camp/event? * Select one optionYesNo If not, why? Is this person in any leadership positions at your church? * Select one optionYesNo Has this person been disciplined by any ministries of the church? * Select one optionYesNo If yes, please explain: Are you aware of any accusations of misconduct involving this person? * Select one optionYesNo Are there any character issues that would hinder this person from being an important part of the counselor team? * Additional Comments? * By checking this box, I certify that this form is filled out as accurately and truthfully as possible. Submit If you are human, leave this field blank.
