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Pastoral Recommendation for Bethel Leadership Institute

Date: April 26, 2024

 

 

First Your Name

First Name*

Last Name*

Phone*
First Your Age Acknowledgment*
First Your Date of Birth*
I certify that I am 18 years of age or older
First Your Signature*
Second Your Name

First Name*

Last Name*
Second Your Date of Birth*
Third Your Name

First Name*

Last Name*
Third Your Date of Birth*
Fourth Your Name

First Name*

Last Name*
Fourth Your Date of Birth*
Fifth Your Name

First Name*

Last Name*
Fifth Your Date of Birth*
Sixth Your Name

First Name*

Last Name*
Sixth Your Date of Birth*
Seventh Your Name

First Name*

Last Name*
Seventh Your Date of Birth*
Eighth Your Name

First Name*

Last Name*
Eighth Your Date of Birth*
Ninth Your Name

First Name*

Last Name*
Ninth Your Date of Birth*
Tenth Your Name

First Name*

Last Name*
Tenth Your Date of Birth*
Parent or Guardian's Email Address

Email*
A signed copy of this waiver will be sent to the email address you provide.
Questions pertaining to BLI applicant

Name of Bethel Leadership Institute applicant that you are recommending: *

Do you recommend the applicant for admittance into the program? Why or why not? *

Does the applicant have any character/spiritual issues of which we should be aware? *
Submission

Thank you for completing this form. Once you submit the Equip team is automatically notified that you have completed the form.

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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