Abuse Prevention Team Forms
1. Care Provider Application Form and Authorization for Criminal Background Checks: This form combines the previous camp personnel file, the Abuse Prevention Team application and the “Permission for background check.” One for each applicant with his/her own written references (one from a pastor), and sign and date it in the appropriate place.
The application form may be copied as needed on white paper.
2. Record Request Form: One form can be used for up to ten requests. Copy as needed. Be sure to note your name, address, and camp on the face of the form, make two copies, mail the original and one copy to the Conference Office (Attn: Ann Buck) and keep one for your records. The form may be copied as needed on white paper.
3. Affidavit of Minors in lieu of background check: Use the white copy as your master and copy as needed on green paper.
4. Affidavit of Non-Certified Care Giver: May copy as needed on yellow paper.
5. Report of Care Provider Applicant Interview: Each applicant is to be interviewed. Use the white copy as your master and copy as needed on blue paper.
6. APT Approved Certification Letter: One for each applicant, copy as needed.
7. APT Denied Certification Letter: One for each applicant denied, copy as needed.
8. Child Sexual Abuse Knowledge Inventory: May be copied as need on ivory paper.
9. Policy: For your information. Copy as needed if any counselors also need additional copies.
10. Entrusted To Our Care – Training video script.
11. Entrusted To Our Care Study – Training video study guide.
12. Report of Actual or Suspected Child Abuse or Neglect - Used to report to the State of Michigan.
13. In-Person / Telephone Reference Check - Use when checking reference of applicants via phone or in-person.
14. Written Reference Check - Use when sending reference questions to an individual.
15. Criminal Background Check Directions - Directions for church background checks.