Reference Check

Your Name(Required)

First Last

Email(Required)

Phone(Required)

Name of individual for whom you're providing a reference(Required)

First Last

1. How long have you know this individual?(Required)

2. In what capacity do you know this individual?(Required)

3. How would you describe him or her?(Required)

4. Do you believe he or she possesses the characteristics necessary for this ministry (especially dependability, emotional stability, commitment, and punctuality)?(Required)

5. Have you had the opportunity to see him or her interact with the population(s) he or she will be serving (children, youth, and/or compromised adults*)? If so, please describe:(Required)

*According to our Safeguarding Policy, a compromised adult is any adult who, due to elderliness or physical, intellectual, and/or neurocognitive disability or emotional and/or psychiatric difficulties, has reduced capacity for self-protection and personal agency.

6. Would you feel comfortable leaving a child, youth, or compromised adult you care about in this individual's care?(Required)

7. Do you feel that he or she would do well in the role that I have described?(Required)

8. Are you aware of any reason why this individual should not be serving in this ministry and with the population(s) he or she will be serving?(Required)

9. To the best of your knowledge, has he or she ever been arrested, experienced drug- or alcohol-related problems, been involved in child molestation or a sexual relationship with a minor, or been involved in the abuse or neglect of a compromised adult?(Required)

10. Is there anything else you want me to know about this individual?(Required)

Reference Check

Reference Check

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