Volunteer Reference Form

On behalf of the applicant, than you for taking the time and effort to fill out this brief reference form. It’s the aim of Gateway Community CRC that our ministries and facilities are a safe place for all to attend. By filling our this form, you have help us out significantly. Thank-you!

Your Name (required)

Your Email (required)

Your Address (required)

Your Phone # (required)

Name of person being referenced (required)

How long have you known the person? (required)

In what capacity do you know this person?

Have you ever witness this person interact with children, youth and/or vulnerable adults? Please describe.

Do you have personal knowledge, or have you ever heard of this person having any problems with the abuse of drugs, alcohol, sex, or abuse of anything else?

If yes, please explain:

Can you recommend that this person be in a position of caring for children, youth or vulnerable adults without any concern, reservation or hesitation?

If no, please explain:

Is there any additional information that you think is important for our church to know about this person?

Thank you for taking the time and effort in completing this reference form.

To the best of my knowledge, I believe the above information to be accurate.
Yes, it is!No