• Confidential Reference Form

  • Format: (000) 000-0000.

  • Information about the Applicant

  • How well do you know the applicant?*
  • What level of communication have you had with the applicant in the last year?*

  • Personality

    Please rate the applicant on a 1-5 scale with 5 being the BEST. Please skip any questions in which you have no knowledge.
  •

  • Suitability for Employment

    Please answer these questions to the best of your knowledge
  • Do you feel the applicant is spiritually, emotionally, and physically ready for a demanding summer?*
  • Do you know of any lifestyle, conduct, or activity in which this individual is or has been involved that could hinder his or her ministry with us, or impede the program’s credibility?*
  • Do you have any knowledge of this person ever being convicted of a child abuse, child neglect, or sexual abuse offense?*
  • Do you have any knowledge of this person having ever been formally accused in a written statement of a crime of any nature or of a pending criminal or civil trial?*
  • Is there any reason you are aware of that the applicant should not be allowed to work with children in a residential camp setting?*
  • Have you ever noticed any racial prejudice in the life of the applicant that would make cooperation with those of another race or nationality difficult?*
  • How well does the applicant receive instruction or deserved criticism from a supervisor or teacher?*
  • How well does the applicant know the bible?
  • Would you hire this person for this ministry if you were in the position to do so?*

  • Please place a check in the box that best describes the applicant. 

    Please CHECK ALL that apply.

    Please skip any questions in which you have no knowledge.

  • Peer Relationships
  • Family / Home Relationships
  • Response to stress / pressure
  • Applicant relates to the opposite sex
  • Level of Spiritual Maturity
  • Ability to work independently and under supervision
  • Working Relationships
  • When conflict arises, this person generally responds with:

  • Digital Signature

    Thank you for taking the time to fill out this reference.
  • By signing below I am stating that in my opinion this applicant is:*
  • Clear
  • Should be Empty:
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