VICTORY CHURCH: VOLUNTEER REFERENCE FORM

Hello! You are receiving this Volunteer Involvement Reference Form from Victory Church in Coitsville, Ohio because a volunteer applicant (see original text or email) has given your name as a reference. Your assesment of the person will help us in guiding his/her involvement into a particular area of ministry on a volunteer level. This information will remain confidential.

If for any reason you would prefer to discuss your answers over the phone, please call the church office at 330-536-2127 and request to speak with Mandy.

Please fill out this form promptly and as accurately as possible. Thank you!

APPLICANT'S INFORMATION (REFER TO ORIGINAL TEXT OR EMAIL)

Today's Date * +

First & Last Name *

YOUR INFORMATION

First & Last Name *

Phone *

Email *

QUESTIONS ABOUT APPLICANT

How long have you known the applicant? *

What is your relationship to the applicant?

How well do you know the applicant?

Very well

Well

Somewhat well

Acquaintances

Comments (if any)

Describe the applicant's character *

Do you have any concerns about the applicants character in regard to working with minors? *

What is the applicants level of commitment when involved in a project, team, task, etc? *

Please explain your answer *

Do you feel this applicant has any problems or limitations which would impede his/her volunteering at the church? *

How well does the applicant work with others?

Please explain your answer *

How well does the applicant follow instructions or direction? *

Very well

Well

Somewhat well

Not well

Comments (if any)

Have you ever observed the applicant working with children in the age groups below (check all that apply) *

Infants-PreK

Kindergarten-6th Grade

7th Grade-12th Grade

No I have not

If so, what was your observation? If not, do you think they would work well with children? *

To the best of your knowledge: Have there been complaints about the applicant behaving inappropriately with minors? *

Yes

No

To the best of your knowledge: Have there been complaints about the applicant behaving inappropriately with adults? *

Yes

No

To the best of your knowledge: Have there been allegations of abuse against the applicant? *

Yes

No

To the best of your knowledge: Has the applicant been disciplined or terminated from a position working with minors due to inappropriate behavior? *

Yes

No

To the best of your knowledge: Would you trust the care of your children or your senior parent to this person? *

Yes

No

Please feel free to add any additional comments about the applicant

Reference's Signature- Please sign this form to let us know that the information you have given is accurate to the best of your knowledge. If we have any questions, we may reach out to you. Thank you for your time! *

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