Annex 3

Name of Person Completing the Form

ICF Role

Contact Details

Name of ICF Children’s and Youth Ministry Worker

Name of Referee

Date Referee Phoned

Question 1: In your experience, what strengths does the worker have in working with children and youth?

Question 2: Please describe anything that would negatively affect the worker's ability to work directly with children and youth.

Question 3: As far as you are aware, is there any reason why the worker should not work directly with children and youth?

Signature

Signed (Type Name for Digital Signature)

Date

Annex 3: ICF Children, Youth and Prayer Ministry Worker Reference Check Form