Coldstream Reference Form

Coldstream Reference Form

Please complete and submit this document within seven days of being contacted by the applicant.
Applicant's Name*

First NameLast Name
In what capacity do you know the applicant?*
How long have you known this applicant?*
Recommender's Name*

First NameLast Name
Above satisfactorySatisfactoryBelow satisfactory
Have you supervised or observed this applicant working with children? If so, in what capacity?*
Above satisfactorySatisfactoryBelow satisfactory
Have you ever known the applicant to have harsh or abusive interaction with a child?*
Are you aware of any instance where the applicant has been reprimanded or investigated for harsh or abusive interaction with a child?*
Is there any reason you know of that this individual would be unsafe to work with children?*
Would you be comfortable placing one of your own children in the care of the applicant? Why or why not?*
Above satisfactorySatisfactoryBelow satisfactory
Above satisfactorySatisfactoryBelow satisfactory

Please choose the answers which best describe the applicant per your experience(s) with them.*

Rows	Area of Weakness	Average	Area of Strength	Unable to Observe
Treats others with respect
Effectively manages time
Is reliable
Shows initiative
Is organized
Demonstrates leadership ability
Is creative
Maintains a positive attitude
Communicates clearly
Is receptive to feedback
Displays spiritual maturity appropriate for their age
Regularly attends a local church
Interacts in a mature and respectful manner with members of the opposite sex
Passionate about the Gospel and sharing it with others

Please indicate your overall recommendation.*
YesNo
Recommender's Best Contact Number*

Area CodePhone Number
Would you like to upload a recommendation letter? (OPTIONAL)

Upload a File

Cancelof
Additional Comments:
Should be Empty: