Clinical Pastoral Education Program Reference Letter
Candidate Information
Program Applied For
Extended Unit (Part time, October - March/ April)
Summer Unit (Full time, late May - early August)
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Reference Giver
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Position
Email
example@example.com
How long have you know the candidate and in what capacity?
How do you evaluate the candidate:
In their potential for pastoral effectiveness?
In their personal commitment to learning?
In their maturity of faith and depth of spiritual development?
If you were seriously ill and hospitalized, how would you feel about him/her visiting you?
Please evaluate the candidate on the following scale:
Critical Thinking
Please Select
Excellent
Very Good
Good
Weak
General Knowledge
Please Select
Excellent
Very Good
Good
Weak
Emotional Maturity
Please Select
Excellent
Very Good
Good
Weak
Creativity
Please Select
Excellent
Very Good
Good
Weak
Interpersonal Skill
Please Select
Excellent
Very Good
Good
Weak
Personal Effectiveness
Please Select
Excellent
Very Good
Good
Weak
Please elaborate on any of the above:
What do you think of the candidate's plan to do clinical pastoral education? (motivation, attitude, readiness for an intensive program, etc.)
Additional remarks or comments:
Signature
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: