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THE
B-PSA - BRITISH COLUMBIA
INTERVIEW
CHECKLIST
NAME OF PERSON BEING INTERVIEWED:___________________________________________________
Confidential interview to be completed by one or two B-PSA Interviewers.
Checklist to be completed following the interview, not in
the presence of the volunteer.
INTERVIEWED BY:__________________________ _____________________________
Name Scouting
Role
________________________________
___________________________________
Name
Scouting Role
Date: Month______________ Day_______________ Year____________
YES
NO
[
]
[ ]
Will accept the Principles of B-PSA Scouting?
[
]
[ ]
Will demonstrate personal values comparable with these Principles?
[
]
[ ]
Will subscribe to the program of the section she/he will work with?
[
]
[ ]
Will be comfortable with, enjoy and care for the age group she/he will
work with?
[
]
[ ]
Will follow the Policy, Organisation & Rules (PO&R) of the
Association??
[
]
[ ]
Will be a good role model?
[
]
[ ]
Will be willing to work
cooperatively with other adults?
[
]
[ ]
Will be willing to be open, honest and objective in evaluations?
[
]
[ ]
Has provided a Police Record Check as requested?
[
]
[ ]
Has provided the 4 character references?
REFERENCE
CHECKS: Four knowledgeable adult references must be provided by the applicant,
and each contacted and checked. (No family members permitted)
|
|
How
long the reference has known the applicant? |
Relationship
to the applicant? |
Applicant
works well with youth? |
Applicant
works well with adults? |
Are
you willing to have the applicant work with children, your own or
others? |
Willing to recommend applicant to BPSA-BC? |
|
Name: Phone No Date Contacted By: |
|
|
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
|
Name: Phone No. Date Contacted By |
|
|
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
|
Name: Phone No. Date Contacted By |
|
|
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
|
Name: Phone No. Date Contacted By |
|
|
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
circle one: yes no uncertain |
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