American Christian University

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High School Extension Minors Bachelor Master Doctoral

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Presentation Form from Pastor or Church Leader

Student's Information

Name:	(full name)
Phone:	(DDD + Telefone )
E-mail:
Address:	, (address + number)
Complement:	County:
City::	State: Country:
ZIP:

Note : You have the legal right to review all information given from your references after your enrollment at ACU. However, you can chose to waiver your right to keep confidential all information given by the persons you presented as your personal reference. If you decide to waive your right, chek the box below.I do not know
I choose to waive my right to read the information given by my references.

Please, complete the following information usign your best knowledge about the person above:

1. The lengt of time of our relationship is:
Less than one year 1-3 years 4-5 years More than 5 years
2. I know this person:
Very Well More or less Casually
3. His (her) Marriage status is:
Single Married Divorced Separated Widow
3.1. Is the relationship of this person with his(her) family members an example of Christian behavior?
Yes No
3.2. If married, his(her) partner is in agreement with his(her) preparation for Ministry?
Comments
4. For how long this person is a Christian?

5. Is this person way of living consistent with Christian life?
Yes No
6. I would evaluate this person in terms of his(her) attitudes toward authority an learning:
Excelent Fair Inconsistent Poor
7. Please, check the box there was true for this persons on the last year. He(she) used:
Cigarette Alcohol Drugs None of thie previous box
8. Is this person presently using some of the above?
Yes No
If yes, please explain:
9. Please, check what applies to this person:
Was in discipline or was expelled from the school Was Involved in questionable moral behavior Had law problems
If you checked any box, please explain:
10. The behavior of this person in the area of sexuality is:
Above any Question Needs to improve Questionable
11. Please, evaluate this person about:
11.1. Regularity on Church Services' assitance
Consistent Freqüent Occasional Rarelly
Comments:
11.2. Church activities participation
Consistent Freqüent Occasional Rarelly
Comments:
11.3. Participation church's ministry
Consistent Freqüent Occasional Rarelly
Comments:
12. Please, list some habilities that you perceive in this person that helps him(her) to do the Christian ministry.

13. I would rate this person's dedication to God and his(her) devotion to Christian principles as:
Very High High Fair Unrealiable
14. I recomend this persos to ACU
Without Concerns With concerns I do not recommend
15. If necessary, our church will help support financially this person
Yes No

Final Comments:



Your Personal Information:

Name:	(Full name)
Your Position:
Phone:	(Area Code + Number )
E-mail:
Address:	, (Address + number)
Complement:	County:
City:	State: Country:
ZIP:
ACU Aluminae:	Yes No Year:

I would like to receive information about ACU's educational programs.

Thank you for your help.