DATE: ______________

To the Right Reverend ____________________, Bishop of _____________________.

We, whose names are hereunder written, testify to our belief (based on personal knowledge or on evidence satisfactory to us) that ____________________________, is sober, honest, and godly, and that he is a communicant of this Church in good standing.

We do furthermore declare that, in our opinion, he possesses such qualifications as fit him to be admitted a Postulant for Holy Orders.

Rector's Signature: _______________________________

Vestry Members Signatures:

Parish Name: ___________________________________________________________

Street Address: __________________________________________________________

City: __________________________________, State: __________ Zip ____________

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