Ministry Leader Referral Form

Your Name

First Name

Last Name

Church or organization you represent:

Your job title/position at the organization:

Organization Website

Organization Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

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STUDENT INFO:

Student's Name

First Name

Last Name

Student's Grade

How long have your known the student's family?

What is your relationship with the family?

How would you evaluate the parent's in their church relationship, attendance and loyalty?

How would you evaluate the parent's in their interest in having their child know and walk with the Lord?

To your knowledge, has this student accepted Jesus Christ as their Savior?

Has this family served in areas of ministry at your church? If so, in what capacity?

In your opinion, what positive contributions would this student and family likely bring to Coastline Christian Academy?

In what areas do you feel we could possibly be most helpful to this student/family?