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Reference Form

Character Reference Form

First Name *
Last Name *
First Name *
Last Name *
In your opinion, is this applicant of good moral character?
To your knowledge, has this applicant been convicted of a crime?
To your knowledge, has this applicant ever abused a child?
To your knowledge, has this applicant ever had a moving vehicle violation?
To your knowledge has this applicant ever had an alcohol or drug problem?
Please contact The Friends Program Director, Jalin Gerdes, if you have questions related to the completion of this reference questionnaire. (phone 308-236-2036 or email information@friendsprogram.net)
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