Kuyper Christian Prep School

Dear Pastor,

This student you are filling this form out for is seeking admission to Kuyper Preparatory School, an independent, board-run, non denominational school. The mission of the school is to humbly provide an excellent classical education, challenging students to understand the responsibilities of personal freedom for the purpose of advancing the Kingdom of God.

Please complete this reference form as it pertains to this family. All responses will be treated with complete confidentiality and will be used only in serving the family as a part of our school community.

Applicant's Name*

Grade Applying For

Parent(s) or Guardian(s)*

Questions

1. Christian Commitment:*

Evident and beyond question
No evidence of commitment

2. Church Attendance:*

Faithful and regular
Occasional
Infrequent
Never

3. Church Relationship:*

Members in good standing
Not members, but exhibit commitment
Not supportive

4. Have any members of the family held a leadership position in the church? Please describe.*

5. Has the family used any special talents within the church body?*

6. Detail the applicant’s regular involvement in church activities.*

7. Do you consider the applicant open to spiritual instruction?*

8. Do you recommend this applicant for admission to Kuyper Preparatory School?*

How long have you known the applicant and his/her family?*

Are you related to the applicant?*

If there are any additional comments you'd like to make please do so below:

Pastor's Information

Pastor's Name*

Pastor's Phone*

Pastor's Email*

Church Name*

Address*

Street Address Address Line 2 City State ZIP Code

Pastor’s Reference Form

Questions

Pastor's Information

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