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United Methodist Church 501 Hampton Lane (Beltway Exit 27B & Dulaney Valley Road) email: towsonumc@towsonumc.org Towson, Maryland 21286 410-823-6511 Elevator is available to access all 3 floors! .
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APPENDIX E
POLICY OF THE TOWSON UNITED METHODIST CHURCH FOR THE PREVENTION OF ABUSE OF CHILDREN AND YOUTH
VOLUNTEER REFERENCE CHECK FORM The Towson United Methodist Church (One Sheet per Reference) Name of Applicant: ________________________________________________________________________________________________ Name of Reference: _______________________________________________________________________________________________ What is your relationship to the applicant? _____________________________________________________________________________ How long have you known the applicant? ______________________________________________________________________________ How well do you know the applicant? _________________________________________________________________________________ How would you describe the applicant? ________________________________________________________________________________ How would you describe the applicant’s ability to relate to children and/or youth? _______________________________________________ How would you describe the applicant’s ability to relate to adults? ___________________________________________________________ How would you describe the applicant’s leadership abilities? ________________________________________________________________ How would you feel about having the applicant as a volunteer Worker with your child and/or youth? _________________________________ Do you know of any characteristics that would negatively effect the applicant’s ability to work with children and/or youth? If so, please describe. _________________________________________________________________________________________________________________ Do you have any knowledge that the applicant has ever been convicted of a crime? If so, please describe. ___________________________ Additional Comments: _________________________________________________________________________________________________________________ Reference inquiry completed by (Print Name):___________________________________________________________________ Signature:___________________________________________________ Date:________________________________________
Please return to: The Towson United Methodist Church 501 Hampton Lane Towson, MD 21286 (410) 823-6511, fax (410) 823-8916
Attn:____________________________
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