3417AI0016

To the Student: Please fill in your information below and give this form (along with the postage-paid envelope found in your paper packet) to someone who knows you both personally and spiritually. This individual should be a minister, pastor or youth director and should not be a family member.

STudenT FIRST name LaST name mIddLe name

PeRmanenT addReSS

CITy STaTe ZIP/PoSTaL Code CounTRy

applicant: I waive my right to review this reference O yes O no

aPPLICanT’S SIgnaTuRe daTe

To the Reference Provider: your student is submitting an application to gordon College. all that is needed to send an admission decision is the following information. Please answer the following questions about the above student and send to gordon College as soon as possible.

youR TITLe (mr., mrs., dr., etc.) youR name ReLaTIonSHIP To THe aPPLICanT

CHuRCH/oRganIZaTIon name

emaIL addReSS PHone numbeR

How well do you know the applicant: O Just by name and sight. O Casually. Have had few personal contacts. O Fairly well. Have had a number of personal contacts. O Have had a close relationship.

Please comment on the quality of the applicant’s:

above below not outstanding average average average observed Christian commitment O O O O O

Involvement in the work of the church O O O O O

emotional maturity O O O O O

Social maturity O O O O O

Positive impact on peers O O O O O

Potential for achievement O O O O O

Leadership skills O O O O O

Personal integrity O O O O O

Christian Faith Reference

255 Grapevine Road

Wenham, Massachusetts 01984-9971

1-866-464-6736

Comment on the applicant’s Christian commitment to the best of your knowledge.

What are the most outstanding positive and/or negative personal traits which the applicant possesses?

are there family or personal factors, either positive or negative, which might affect the applicant’s success at gordon? O yes O no Please explain.

your specific recommendation: O Strongly recommend O Recommend O Recommend – may encounter some difficulty O do not recommend O Prefer not to make a recommendation

Please expand upon any information supplied on this form as you deem necessary, or make any additional comments below.

SIgnaTuRe daTe

Thank you for your time in filling out this recommendation. Please return the completed form in the postage-paid envelope or mail to: office of admissions, gordon College, 255 grapevine Road, Wenham, massachusetts 01984-9771