Volunteer Reference Form

Thank you for being a reference for someone looking to Volunteer this summer at Innabah.  You are being requested to provide a personal reference as part of the application process.  This reference will be treated confidentially.

Innabah Program Center is one of four facilities of the Eastern PA Conference of the United Methodist Church that provides summer camps for children, young adults, and campers with special needs.   We seek to employ qualified persons who have an active relationship with Jesus Christ and are willing to share their faith with campers and other staff members.  Your reference will provide helpful insight into the applicant’s background and assist us in making a fair decision. Please fill in the form below and click the Submit button when complete.  Thank you for your help in this very important matter. 

Your Name *
Your Name
Name of Applicant *
Name of Applicant
How long have you known the applicant? *
Under what circumstances have you been acquainted? *
If you responded "Other" to the previous question, enter your circumstances here:
Sense of responsibility *
Initiative *
Cooperation *
Emotional Stability *
If you entered "Other" on the previous question, please explain:
Role Model to Peers *
By their daily example, would you say this person would serve as a positive Christian role model for our campers? *
To the best of your knowledge, does this person consume alcoholic beverages? *
Use tobacco products? *
Use illegal drugs? *
To the best of your knowledge, has this person ever caused any Child Abuse of any kind (i.e., verbal, sexual, or physical)? *
Would you feel comfortable if your child was under the direct supervision of this applicant during their stay at camp? *
Do you recommend the hiring of the applicant as a volunteer? *
Date
Date
Phone
Phone

Innabah accepts applicants of any race, color, and national or ethnic origin.  Your prompt response is greatly appreciated.