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PASTORAL REFERENCE

Pastoral Reference Form

If the program you plan to attend requires a pastoral reference, please share this page with your pastor and have them complete the form below.

CONFIDENTIAL PASTORAL REFERENCE
Applicant's Name*
First Last
Pastor's Name*
First Last
Church Name & Denomination*
Church Address*
Street Address Address Line 2 City State ZIP Code
Pastor's Church Phone*
Pastor's Church Email*
Questionairre
DEAR PASTOR: Please be so kind as to answer the following questions and complete the checklist. (Any questions, call Ashley Rollinson, Director 315-396-1886 or e-mail: ashley@lightoftheworldballet.com)
How long have you known the applicant and what pastoral position of authority do you have over the applicant?*
How would you describe applicant’s present walk with the Lord?*
Has the applicant shown him/herself to be submissive to authority having a teachable attitude?*
Is the applicant responsible and committed?*
What are the applicant’s strengths and weaknesses?*
Is the applicant an energy giver or energy taker?*
Anything else that LIGHT OF THE WORLD BALLET should be aware of?*
SPIRITUAL INFORMATION
Please number the following on a scale of 1 to 4 (1=Poor, 2=Fair, 3=Good, 4=Excellent)
Church Attendance*
- 1
- 2
- 3
- 4
- 5
Spiritual Motivation*
- 1
- 2
- 3
- 4
- 5
Grateful Spirit*
- 1
- 2
- 3
- 4
- 5
Church Involvement*
- 1
- 2
- 3
- 4
- 5
Spiritual Growth Observed*
- 1
- 2
- 3
- 4
- 5
Servanthood*
- 1
- 2
- 3
- 4
- 5
Personal Devotions*
- 1
- 2
- 3
- 4
- 5
Moral Standards*
- 1
- 2
- 3
- 4
- 5
Teachable Spirit*
- 1
- 2
- 3
- 4
- 5
CHARACTER INFORMATION
Please number the following on a scale of 1 to 4 (1=Poor, 2=Fair, 3=Good, 4=Excellent)
Maturity*
- 1
- 2
- 3
- 4
- 5
Appearance (Modesty)*
- 1
- 2
- 3
- 4
- 5
Self Image*
- 1
- 2
- 3
- 4
- 5
Disposition*
- 1
- 2
- 3
- 4
- 5
Coping with Personal Problems*
- 1
- 2
- 3
- 4
- 5
Personal Motivation*
- 1
- 2
- 3
- 4
- 5
Emotional Stability*
- 1
- 2
- 3
- 4
- 5
Response to Pressure*
- 1
- 2
- 3
- 4
- 5
Follows Instruction*
- 1
- 2
- 3
- 4
- 5
Enthusiasm*
- 1
- 2
- 3
- 4
- 5
Adaptability/Flexibility*
- 1
- 2
- 3
- 4
- 5
Teamwork/Cooperation*
- 1
- 2
- 3
- 4
- 5
Reliability*
- 1
- 2
- 3
- 4
- 5
Openness*
- 1
- 2
- 3
- 4
- 5
Judgment/Common Sense*
- 1
- 2
- 3
- 4
- 5
Honesty*
- 1
- 2
- 3
- 4
- 5
Financial Responsibility*
- 1
- 2
- 3
- 4
- 5
Positive Attitudes*
- 1
- 2
- 3
- 4
- 5
Creativity*
- 1
- 2
- 3
- 4
- 5
Pastoral Consent
As Pastor of the applicant, I endorse the applicant’s involvement with SUMMER DANCE OUTREACH and feel confident that he/she understands this commitment and maintains spiritual and emotional maturity needed to be a part of this City mission.*
- Agree
- Disagree

About Us

Light of the World Ballet consists of a School, Trainee Program, and a Professional Ballet Company. Light of the World Ballet serves families, communities, ministries and organizations locally, nationally and internationally by sharing the truth of Jesus Christ in places where the Gospel has never been heard and ministering the love and power of the Holy Spirit to the Body of Christ. This vision is being accomplished through the medium of ballet and dance.

Contact Us

Mailing Address
PO Box 44
Syracuse, NY 13209

School Address
3537 James Street,
Syracuse, NY 13206

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