Next Step: Volunteer Background Check Reference Form • North Central Church

Your Name *

Applicant's Name *

What is your relationship to the applicant? NOTE: If you are a relative of the applicant, you are not permitted to be a reference. *

Friend

Co-Worker

Neighbor

Other

If you selected other, please describe the nature of your relationship to the applicant.

How long have you known the applicant? *

Under 2 years

2-5 Years

5-10 Years

10+ Years

How would you describe the applicant's character? *

Do you have any reservations about recommending the applicant to work with minors? *

Yes

No

If you selected yes, please explain your reservations.