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Activ8Her Coordinator Ministerial Reference Form
Dear Pastor, 
 Would you please complete the attached assessment form for the candidate who made the request that you do so? Your response will be confidential. We have received an application from her and she would like to be considered as a chapter coordinator for Activ8Her. If you have any questions, feel free to write us at activ8hernow@gmail.com. You can find out more about Activ8Her at activ8her.org or by emailing activ8hernow@gmail.com. 
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Email *
Name of Applicant: *
How long have you, or your associates known the applicant?  
In what areas has the applicant previously served within the church? *
Does she currently serve? If so, in what capacity? *
If so, in what capacity?
Does the applicant have a servant’s heart, a love for God, and the family of God? *
Does the applicant have a teachable spirit? *
How has the applicant shown that she is able to serve as part of a team? *
Are you aware of any concerns in her life which would impact her ability to serve as a leader within Activ8Her? (ex. Unresolved issues such as: lack of repentance, unforgiveness, impurity, anger)? *
Would you recommend this applicant as a Coordinator for Activ8Her without reservation? Yes/No? (If no, please explain) *
If No, please explain.
Your Name/Title: *
Church Affiliation and Address:
Date:
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