Reference Form

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VOLUNTEER candidate reference form

Thank you for taking a few minutes to complete this questionnaire on a friend or acquaintance that has submitted your name as a reference. The items with a red star by them are required fields. Please complete then click on the SUBMIT button at the bottom of the page.

Your Name: *

Email *

Your Phone Number: *

Name Of Person You Are Referencing: *

City Of Person You Are Referencing: *

What area is the applicant desiring to work? (If Known) *

How long have you known this person? *

More than 10 years More than 5 years More than a year Less than a year

In your opinion, do they seem to make their relationship with the Lord Jesus a top priority? What is the reason for your answer? *

Is there any reason you could think of that should hinder this person from working in a ministry to children? *

Yes No I prefer not to answer

If yes, please explain *

Is there anything that would call into question this person being entrusted with the supervision, guidance and care of children or young people? *

Yes No I don't know or prefer not to answer

If yes, please explain *

Do you know if this person has ever been accused or convicted of child abuse? *

Have you ever seen this person working with or around children? *

Yes, they are great with children I've never seen them around children I couldn't see them working with children I prefer not to answer

Is there any other comment you feel would be helpful? *

Submit

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