CHRISTIAN CHARACTER REFERENCE

Relative or Personal Friend
PRINT AND MAIL TO:
Free Grace Seminary - Admissions Office - P.O. Box 2707 - McDonough, GA 30253-1741

Applicant: Please complete and sign:

APPLICANT'S NAME: ___________________________________________________________________

Waiver of confidentiality: “I the undersigned, hereby voluntarily waive the right of privilege to inspect or challenge the content and comments expressed in this reference. I expect that the observations made shall remain confidential between the reference provider and Free Grace Seminary.”

DATE: _____________________________  SIGNATURE OF APPLICANT: ____________________________________________

TO THE PERSON COMPLETING THIS FORM: Please answer the questions carefully.

1. How long have you known the applicant? _____ years _____ months.
In what capacity? ____________________________________________________________________________________________

2. As far as you know, has s(he) been born again by faith in Jesus Christ? ______

3. Has s(he) attended church regularly? _____; participated in church activities? _____;

done any Christian Service? If so, list: _____________________________________________________________________________

4. Does s(he) come from a Christian Home? ______; as well-disciplined home? ______;  receive encouragement from home? ______.

5. Is s(he) inclined to receive instruction? ______.

6. Does s(he) have any significant limitations in the physical, mental, emotional, or social realms?
If so, explain: _________________________________________________________________________________________________

7. Does s(he) have any special talents or abilities?

Please list: __________________________________________________________________________________________________

8. Have you any reason whatsoever for lack of confidence in the applicant? _____.
If so, explain: _________________________________________________________________________________________________

9. What degree of success as a student would you predict for this applicant? 

Superior ______ Excellent ______ Above Average ______   Average ______  Below Average ______ Failure ______

10. If you were a member of the Admissions Committee at FGS, would you vote to accept him/her as a student?
Enthusiastically ______ Willingly ______ Questionably ______ Not at all ______

Please sign and mail to the Office of Admissions:

Signature: _______________________________________________ Date: ______________

Address: ___________________________________________________________________

Phone: _________________________ E-Mail Address: __________________________

(August 2011)