GLORIA DEO CHARACTER REFERENCE FORM
Applicant Name: ______
The above applicant has applied to bea member of Gloria Deo Co-Op and has listed you as a reference. A personal recommendation gives insight into a person and helps us determine if they are a good match for our Cooperative which includes a ministry with children. Please be candid and objective in your answers. This form will remain confidential.
How long have you known the applicant? ______
In what capacity? ______
Is there anything that would call into question this applicant being entrusted with the supervision, guidance and care of children or young people? If yes, please comment on back.______
Has this applicant ever been accused or convicted of child abuse? ______
What are the applicant’s strengths? ______
What are the applicant’s weaknesses? ______
Does the applicant work well with others? If no, please comment. ______
______
How well does this person control his emotions? ______
______
Please circle a response.
1) How well do you know the applicant?
CasuallyWellVery Well
2) To your knowledge, does the applicant attend and participate in the ministry of the church?
Yes – which ministry?______No Unsure
3) Do you have contact with the applicant outside of church?
Yes No
4) How would you rate their standard of Christian living?
ExcellentVery GoodGoodFairPoor
5) How would you rate the applicant’s relationship with others?
ExcellentVery GoodGoodFairPoor
6) How would you rate the applicant’s general outlook on life?
ExcellentVery GoodGoodFairPoor
7) How would you rate their attitude toward authority?
ExcellentVery GoodGoodFairPoor
8) What is the applicant’s work ethic?
DependableUnreliableNot sure
9) Would you recommend we accept the applicant?
YesNoNot sure
10) Would you allow your child to be supervised by this person?
YesNoNot sure
Signature: ______Date: ______
Name: ______
Address: ______
City, State, Zip: ______
Telephone: ______Email: ______
Use the space below for comments.
BR 11/07, 2008 Reference Form