REFERENCE FOR CHILDREN/YOUTH WORKER

Instructions to applicant for children/youth work: Provide the link to this form to three adult references (not relatives). Ask them to complete and submit the form.

NOTE: "Children/youth work" means any position that involves the supervision or custody of minors, whether serving as a nursery attendant, Sunday school teacher, or youth group leader or assistant.

Name of Applicant:

First Name

Last Name

Reference Information

First Name

Last Name

Email

Phone Number

Reference Questions - Please answer about the applicant to the best of your ability.

How long have you known the applicant?

In what capacity have you known the applicant?

Describe the applicant's character, personality and temperament:

Describe the applicant's strengths (gifts, experience or abilities) for children/youth work:

Describe any known weakness for children/youth work:

To the best of your knowledge, has the applicant ever been accused, investigated, arrested, or convicted for neglect, physical abuse, sexual abuse, assault or any other acts of violence?

No

Yes

If yes, please explain:

What is your overall recommendation?

I recommend the applicant for children/youth work.

I believe the applicant is unsuited for children/youth work.

Additional Information:

Date Input

Reference Signature