Pastoral Referral

Dear Pastor,

The family submitting a request for your referral has applied for their child(ren) to enroll in Northland Christian Schools. This form is to be filled out by pastors only - at the request of the applying family.  Please complete this form with as much detail as possible within 7 days of the family’s request. This information will be kept confidential and will not be shared with the family. Student admission is contingent on receiving this form. If you have questions, please contact the Admissions Office at or (816) 548-2222.

Thank you,
Northland Christian Schools

Name *
How long has the family attended your church? *
How long have you known the family and child? *
Do the parents and children bear testimony to a personal relationship with Jesus Christ? *

Interested in becoming a Northland Christian church partner and investing in the Kingdom education of 450+ students? Check out our Church Partnership Page or email