Confidential Reference Form

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St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

revised Mar. 1, 2016

Applicant

Name of Applicant*

The above named person (“the Applicant”) is applying to St. Therese School of Faith and Mission for admission to our nine-month program of Catholic faith formation and community living. We request your candid assessment of this person and their suitability for the School of Faith and Mission.

Reference Information

Name*

Address* City* Prov/State* Postal/Zip Code* Daytime Phone #* Email Address*

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

We appreciate your time in completing this form. All information you provide will remain confidential.

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

Submit Reference

I, the Referrer, have responded truthfully, to the best of my knowledge, to the above questions about the Applicant. I acknowledge that the contents of this form will be held in the strictest confidence by St. Therese School of Faith and Mission Inc. and will not be shared with the Applicant or any other parties.

I agree to the above*

Submitting Reference for:

Referer's Name

Date

Verification

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

Student Reference has been submitted.

Thank you for taking the time to let us know a little bit more about the person that asked you act as a Reference in support of their application to St. Therese School of Faith and Mission. Your responses will be held in confidentiallity and will not be shared with the Applicant.

If we have any further questions, we may contact you. If you have any further quesitons about the program or information about the application, please contact a member of our Admissions Team.

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St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

Student Reference has been submitted.

St.Therese Institute

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St. Therese Institute'sSchool of Faith and MissionNINE MONTH FAITH FORMATION PROGRAM — CONFIDENTIAL REFERENCE FORM —

St. Therese Institute'sSchool of Faith and MissionNINE MONTH FAITH FORMATION PROGRAM — CONFIDENTIAL REFERENCE FORM —

St. Therese Institute'sSchool of Faith and MissionNINE MONTH FAITH FORMATION PROGRAM — CONFIDENTIAL REFERENCE FORM —

St. Therese Institute'sSchool of Faith and MissionNINE MONTH FAITH FORMATION PROGRAM — CONFIDENTIAL REFERENCE FORM —

Student Reference has been submitted.

St.Therese Institute

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —

St. Therese Institute's
School of Faith and Mission
NINE MONTH FAITH FORMATION PROGRAM
— CONFIDENTIAL REFERENCE FORM —