Church Reference

To church leader: Thank you for helping us with this referral. It will assist us in evaluating the applicant. Your confidential information will be used in assessing the student's application for admission. Because this reference is being submitted online, we may contact you to confirm the information submitted.

Please keep in mind that the applicant's file will not be reviewed until this form is completed.

Applicant Information
Please enter the applicant's information below.

Student's First and Last Name:*
Student's City / Town / Locality: *
Student's State:
Country (if other than USA):
Evaluation
Please evaluate the applicant by checking all characteristics that apply:
1. Leadership:	never leads good organizer leads when asked excellent leadership unable to observe
2. Cooperation with others:	causes friction usually cooperative avoids group activities works well with others unable to observe
3. Concern for others:	self-centered considerate indifferent unselfish unable to observe
4. Choice of associates:	questionable somewhat discerning careless discerning in friendships unable to observe
5. Level of motivation:	strong determination lacks motivation positive attitude shows little interest unable to observe
6. Respect for authority:	disrespectful generally respectful critical honors those in authority unable to observe
7. Spiritual integrity:	inconsistent attitude and practices high values indifferent spiritual stance consistent moral standards unable to observe
8. How long have you have you been acquainted with the applicant?
9. How well do you know the applicant?	very well well casually
10. To the best of your knowledge, has the applicant made a personal commitment to Jesus Christ?	Yes No Unsure
11. In what areas, if any, would the applicant need special assistance?
12. Please feel free to provide additional remarks which would assist in evaluating the applicant.
13. LeTourneau University seeks students who profess a vital Christian experience or are open to instruction in the Christian faith. The college admits students who are most likely to profit from LeTourneau's distinctly Christian emphasis and who are compatible with the standards of the university. To your knowledge, would the attitude or present conduct of the applicant make it difficult for him/her to adjust to these requirements?	Yes No
14. If yes, please explain.
15. Do you recommend the applicant for admission to LeTourneau University?	Yes No Please contact me to discuss
Referent Information
Your Name:*
Your Title:*
Church you Attend:*
Email address:
Address:*
City:*
State:*
Zip/Postal Code:*
Country:
Daytime Phone (For verification purposes only):*
Preferred time of phone contact (AM or PM)"
All fields marked with an asterisk (*) are mandatory.