Referee Report

Thank you for agreeing to act as a referee for an applicant to Scouts ACT.

Please answer the following questions based on your experience of the applicant in any setting. If you have not seen them with children directly, that is completely fine — simply answer based on their general behaviour, reliability and judgment.

Your responses are confidential and help Scouts ACT meet our Child Safe obligations.

SECTION 1 - Applicant Details

Applicant's full name (The person for whom you are providing this reference) *

Which Scout Group or Unit does the applicant wish to join? (This information is provided in the email you received) *

LIC *

LIC Email (Functional) *

SECTION 2 — About You (the Referee)

Your full name *

Are you 18 years of age or older? *

YesNo

Are you related to the applicant? (Examples: The applicant's parent, child, sibling, grandparent, aunt/uncle, cousin, partner, spouse, in‑law, step‑family) *

YesNo

How long have you known the applicant? *

Less than 2 years2 years or longer

Referee Ineligibility

Based on your responses to the eligibility questions, you are not eligible to act as referee for the applicant.

Please complete the form by pressing the SUBMIT button below.

Thank you for your time.

Your phone number *

Your email address *

How do you know the applicant? For example: I am their employer, manager, colleague, friend, neighbour, leader in the same scout group, etc. *

Are you currently a member of Scouting? *

YesNo

SECTION 4 - Observations and Suitability Ratings

Have you observed the applicant interacting with children or young people (in any setting, formal or informal)? Examples may include family gatherings (not their own children), community events, sport, school events, Scouting events, or social settings. *

Yes No

Please describe the situation(s) and your observations *

For each statement below, please provide a rating from 1 to 5, based on your own direct experience with the applicant:

Significant concerns / very poor
Some concerns / below expectations
Acceptable / meets expectations
Good
Excellent / consistently strong

Please explain your ratings and include examples where possible. *

Are you aware of any behaviour, complaints, or situations (in any context) that may be relevant to the applicant’s suitability for a child‑related role? *

YesNo Unsure

Please briefly explain *

Based on your knowledge of the applicant, do you believe they are suitable for a role supporting children and young people at Scouts ACT? *

YesNo

Please provide brief comments explaining your assessment of the applicant’s suitability. *

By submitting this form, I confirm that, to the best of my knowledge, the information provided is true and correct, and that I am the person named as the referee. *

Date submitted *

Date completed *

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