Clearance Interview Report

Clearance Interview Report
Date of Interview*

MonthDayYear
Date
Name of Candidate *

First NameLast Name
Name of Congregation*
Name of Interviewer #1*

First NameLast Name
Email of Interviewer #1*
example@example.com
Name of Interviewer #2*

First NameLast Name
Email of Interviewer #2*
example@example.com
Name of Interviewer #3 (If Applicable)

First NameLast Name
Email of Interviewer #3 (If Applicable)
example@example.com
The Candidate above is recommended/not recommended at this time: *
The following observation were made that support clearing the Candidate.
The Candidate may have some special insights/gifts to offer the Presbytery.
The Candidate was given the Sexual Misconduct Policy and will submit a signed copy:
The Candidate's Statement of Faith will be completed and submitted by:

MonthDayYear
Date
The Background Check form will be submitted by:

MonthDayYear
Date
Plans for and list of commissioners will be submitted to the Presbytery by Date.
The Candidate is not recommended for clearance at this time for the following reasons:
Email of Candidate (They will receive an automated link to the Sexual Misconduct Policy and Background Check form.)
example@example.com
Name of Interviewer #1*

First NameLast Name
Signature*

Clear
Please verify that you are human*
Should be Empty: