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KidZ at Heart Church Endorsement Form
APPLICANTS: Please send this form to a pastor (or key church leader) to complete and return an evaluation

EVALUATOR: The applicant listed below is applying for a ministry position or to serve on a short-term missions trip with KidZ at Heart International. Please fill out and submit this form directly to KidZ at Heart.

Name of Applicant *
Your answer
Name of reference *
Your answer
Best contact phone number *
(XXX)XXX-XXXX
Your answer
Relationship to Applicant (Check all that apply) *
Required
How long have you known the applicant? *
Your answer
During what years? *
Your answer
How well do you know the applicant *
Personal Character & Appropriateness for Work with Minors
*
No
Yes
Unknown
Does the applicant engage in the inappropriate use of drugs
Does the applicant use tobacco in any form?
Does the applicant engage in the excessive use of alcohol?
Is the applicant prone to the use of pornographic materials?
Does applicant engage in any form of inappropriate sexual behavior?
Has the applicant been arrested for, accused or convicted of a crime?
Has applicant ever been accused of wrongdoing with a minor?
Please explain any "Yes" answers above.
Your answer
Personal & Spiritual Maturity
*
Yes
No
Unknown
Applicant represents what I believe to be a godly Christian lifestyle:
Applicant is  regular in church attendance and involvement:
Applicant works well with others in a variety of situations:
Applicant deals well with stressful situations:
Applicant maintains healthy relationships at work and home:
Applicant has the spiritual maturity to work with children and adults:
Please explain any "No" answers above:
Your answer
Ministry Skills & Abilities
*
Yes
No
Unknown
Applicant works well with children of a variety of ages:
Applicant is able to lead adults in accomplishing church work:
Applicant is an accomplished teacher and leader:
Applicant is able to recruit other adults for ministry tasks:
Applicant is able to administrate a variety of ministry details:
Please explain any "No" answers above
Your answer
General Concerns
What concerns, if any, would you have trusting this applicant to care for your own children?
Your answer
Is there any reason we should not consider placing this person in a position of responsibility with children and / or youth? *
If you answers yes above, explain:
Your answer
Please tell us anything additional that we should know about this applicant
Your answer
By pressing Submit, you are acknowledging that all of the information above is correct.
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