Applicant's Name *

First Name

Last Name

Your Name *

First Name

Last Name

Phone *

(###)

###

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How well do you know this person? *

Very Well

Well

Casually

Do you know any reason why this person shouldn’t work with children? *

Yes

No

What is this person’s attitude toward authority? *

Excellent

Good

Average

Poor

What is this person’s general outlook on life? *

Positive

Somewhat Positive

Somewhat Negative

Negative

Does this person work well with others? *

Yes

No

Are you aware of any unbiblical sexual tendency in this person? *

Yes

No

What is this person’s work ethic? *

Dependable

Mostly Dependable

Somewhat Dependable

Undependable

How would you rate this person’s standards for Christian living? *

Excellent

Above Average

Average

Below Average

Poor

Is the applicant living a consistent Christian life? *

Yes

No

Have you noted any particular personality weaknesses? *

Yes

No

Spiritual Life: *

No Interest

Small evidence of growth

Average

Shows Growth

Don't Know

Initiative: *

Requires constant oversight

Succeeds, if always directed

Performs assigned tasks

Goes beyond what’s required

Don’t know

Influence on Others: *

Negative influence

Mostly negative

Mostly positive

Always good influence

Don’t know

Responsibility: *

Irresponsible

Shows some dependability

Usually reliable

Capable of much responsibility

Don’t know

Leadership: *

Always a follower

Tries but usually fails at leadership

Assumes occasional leadership

Good

Don't Know