CHURCH LEADER REFERENCE FORM

People involved on team at New Wine events carry considerable responsibility. New Wine needs to be assured that those engaged in ministry are appropriately gifted and experienced, are willing to accept training and will follow the guidelines set out for this ministry. 

Your name has been given to us as church leader for someone applying to be on a team. We would be grateful if you could complete the following form, which should only take a couple of minutes to complete.

If you would prefer to talk to a New Wine staff member about an applicant instead of completing this form, please send us an email to teams@newwine.org.nz and someone will be in touch.

YOUR DETAILS

Your name

Your mobile

Your email

Your church

APPLICANT REFERENCE

Applicants name

Relationship to the applicant

How long have you known the applicant?

Do you feel you know the applicant well enough to complete a reference?

Please select... Yes No

Please provide the name and contact details of somebody more appropriate to complete the form

Are they a committed Christian? (Answering no in this section will not automatically disqualify the applicant.)

Please select... Yes No

Are they actively involved in church life? (Answering no in this section will not automatically disqualify the applicant.)

Please select... Yes No

Is the applicant reliable?

Please select... Yes No

Is the applicant able to follow instructions from a team leader?

Please select... Yes No

General character (Briefly describe the applicants general character. If you have answered no to any of the previous questions (about reliability, team work and ability to follow instructions), please use this space to expand.) 

Additional needs (Briefly describe any medical, physical or emotional needs the applicant has which could affect, or even prevent, them serving on team, or would mean that they need additional support?)

Do you consider the applicant suitable to work with children and young people?

Please select... Yes No

Inappropriate behaviour (Have you, or any other church leader, to the best of your knowledge and belief, ever had to speak to them about inappropriate behaviour towards a child, a young person or any aged person?)

Please select... Yes No

Please comment

To your knowledge has the applicant ever been convicted of an offence in and criminal or civil proceedings? (Other than minor motoring offences)

Please select... Yes No

Please advise relevant details

To your knowledge, has the applicant's conduct ever caused mental or physical harm to any person?

Please select... Yes No

Please advise relevant details

 

If you have further people to do a reference for, please click the "Add another reference" link below. Otherwise complete the declaration below and hit submit.

DECLARATION

I certify that the information I have provided in this reference is true to the best of my knowledge and belief.

Please select... Yes No