Referral Form

Will you help find the best candidates for Pivot?

If so, please identify your top recommendation(s) of low-income, working-age women who are:

  • ready to make a change in life;
  • without minor dependents in the home;
  • willing to commit and to participate in weekly classes, building community with others;
  • open to a Biblical foundation and a one-on-one Christian mentor.

Please answer the following questions as you understand each referral’s current situation while honoring your confidentiality agreement.  Required fields are marked with an asterisk (*).

Please be sure to hit SEND (at the bottom of the form) when it’s complete.

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