If this was a PAST employer/employee or volunteer relationship, would you re-hire them in the furture? *

Yes

No (If no, please explain below)

Do you feel the Applicant is appropriate for the area of ministry they are applying for? *

Yes

No (If no, please explain below)

Do you feel this person is trustworthy and reliable? *

Yes

No (If no, please explain below)

We work with a vulnerable population and the Applicant may either work directly or indirectly with them. Do you feel the Applicant is appropriate for interaction with people who may be in crises, have mental health and/or addictions issues? *

Yes

No (If no, please explain below)

Does the Applicant, as far as you know, have any limitations which might impact upon his/her ability to perform a task or assignment? *

Yes (If yes, please explain below)

No

Do you know if this person has had any financial difficulties, or a history of drug or alcohol abuse? *

We work with a vulnerable population who present with these issues.

Yes

No

I don't know

Your Name *

First Name

Last Name

Phone

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###

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