Pregnancy Care Center Director Reference Form Pregnancy Care Center Director Reference Form PCCDirectorReferenceForm Pro-Life Nurse Mission Applicant’s Name First Name * Last Name * The above-named individual has applied for specialized missionary nurse training with CompassCare Pregnancy Services. CompassCare would appreciate a confidential statement from you concerning the applicant’s conformity to the qualities listed below and their expected ability to comply with CompassCare standards of practice. Please include how long and in what capacity you have known the applicant. Desired Qualities – As part of the CompassCare Pro-life Nurse Missions training program, the applicant will work for or with women who may be facing the decisions of an unplanned pregnancy. Some of the qualities desired in staff and volunteer are: • A genuine commitment to Jesus Christ as Savior and Lord of their life. • A willingness to give of themselves with compassion to the women they will serve. • Dependability and responsibility to apply what they have learned with excellence. • An ability to uphold their commitments to the Mission, Values, and Policies of CompassCare. Your comments concerning the applicant’s conformity to the qualities listed above: Please check the best rating for the areas listed. Dependability Above Average Average Below Average Spiritual Maturity Above Average Average Below Average Communications Skills Above Average Average Below Average Initiative Above Average Average Below Average Your Information Your Name * Pregnancy Care Center Name * Email * Phone * Street Address City State Zip SIGNATURE (Please type your full name) * DATE * Captcha Submit If you are human, leave this field blank.
