Reference Check Interview Form References are required for each applicant prior to their certification to work with children, youth, or vulnerable persons. The information that you share will be held in strict confidence. Applicant's name: ________________________ Reference name: ________________________ Reference address: _________________________________________ Reference phone and e-mail: __________________________________ 1. What is your relationship to the applicant? ___________ 2. How long have you known the applicant? _________________________ 3. How well do you know the applicant? _________________________ 4. How would you describe the applicant? ___________________________ 5. What are some ways you'd like to see this person grow or develop? ______________ ___________________________________________________________________________________ 6. Have you observed this person in a frustrating situation? What happened? _______ ___________________________________________________________________________________ 7. What would I not know about this person merely from reading an application or meeting one time? __________________ 8. How would you describe the applicant's ability to relate to children, youth, or vulnerable persons?__________________ 9. Do you know of any characteristics that would negatively affect the applicant's ability to work with children, youth, or vulnerable persons? _____________________________ 10. Do you have any knowledge that the applicant has ever been convicted of a crime? If so, please describe. __________________ 11. Who else would be able to give me insight into this person? ________________ 12. Please list any other comments you would like to make: __________________ Signature _____________________________ Date __________________ We appreciate your time in answering these questions as we strive to do everything we can to protect our children, youth, and vulnerable persons. Thank you. Get the right leaders in the right places. Prepare for the Meeting Follow these four steps to get ready for the orientation. The New Reality In Motivation How to deal with the growing gap between key leaders and the grassroots. | ||||||||||||||||




