Online Reference Form

All information will be kept confidential. Please fill out to the best of your knowledge and ability.

About the applicant

Name of applicant *

First and last

How long have you known the applicant? *

In what capacity? *

Applicant is applying to be: *

A Volunteer

A Staff member/Full time summer counselor

Unsure

To your knowledge is this person a Christian? *

Yes

Unsure

Please explain further if you can *

At what place do you feel the applicant is at in his/her spiritual life? *

How does the applicant demonstrate a lifestyle committed to spiritual growth and integrity?

Carries out principles and convictions constantly and boldly even in the face of obstacles

Acts according to convictions in most situations

Fails to carry out convictions under stressful situations

In your opinion does the applicant come from a healthy place in life to serve? *

Yes

Please explain: *

At LBE we work with vulnerable children and youth. Do you have any concerns about the applicant being placed in a position of trust with our kids or teens? *

Yes

Please explain: *

What type of influence do they exert on others? *

Is the applicant appropriate and effective in their interaction with youth and/or children? *

Yes

Has not witnessed interactions

Please explain *

How does he/she respond to authority?

Please do you best to describe the applicant by checking the appropriate boxes

Responsibility

Excellent - Follows through and goes over and above

Good - Follows through

Average - Usually is dependable

Poor - Generally unreliable

Leadership

Excellent - Very successful in leading others

Good - Normally successful in directing and leading others

Average - Usually follows the lead of others

Poor - Poor leader, incapable of directing others

Concern for Others

Excellent - Deeply sensitive, puts others before self

Good - Sensitive to others, generally puts others first

Average - General concern for most others

Poor - Concern only for friends, lack of interest for others

Any additional comments?

Do you recommend this applicant to volunteer or work with our programs? *

Recommend

Recommend with reservations

Do not recommend

Please explain *

About you

Name *

First and last

Phone number *

Email address

About the applicant

About you

Contact Us

Search