HDCH Membership Application Appendix B - Pastoral Reference Form This form is an appendix to the HDCH Membership Application Form. The Membership Policy requires that the applicant confirm that they “are a sincere attendee/member at a Christian Church.” In this case, a “Christian Church '' is understood to subscribe to and adhere to similar beliefs to that of HDCH. The Board of HDCH kindly asks you to respond to the questions/statements below. Please return the completed form to the school by mail or email. Name of Applicants: _______________________
Name of Pastoral Reference: _____________________
Church Name: ____________________________
Church Address: ______________________________
Does your Church affirm the following teachings and beliefs? _____ We believe that the Holy Bible is God's inspired and infallible word. _____ We believe that God's word alone is a sufficient rule of faith and practice. _____ We believe Christ Jesus died once for all to atone for our sins. _____ We believe we are saved by grace alone, apart from works, through faith in Christ Jesus. _____ We believe in all the statements contained in the Apostle's Creed, Nicene Creed and Athanasian Creed. Please complete the following reference questions: 1. How long have you known the family?
2. Are the parents current attendees/members, in good standing, of your church?
3. Are they faithful in church attendance? 4. As far as you know, is their lifestyle consistent with belief in Jesus Christ as Lord and Saviour?
5. Other comments you may wish to add:
Name: ______________________________________ Email: ______________________________________ Phone: ____________________________________ Signature:____________________________________ Date: ______________________________________
Please return this completed form to: tvandyk@hdch.org or mail to HDCH Attn. Tina VanDyk 92 Glancaster Road, Ancaster, ON, L9G3K9