WMC – 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.

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: Pamela Stewart) and keep one for your records. The form may be copied as needed.

3. Affidavit of Minors in lieu of background check for those under 18 years of age.

4. Report of Care Provider Applicant Interview: Each applicant is to be interviewed. Copy as needed.

5. APT Approved Certification Letter: One for each applicant approved, copy as needed.

6. APT Denied Certification Letter: One for each applicant denied, copy as needed.

7. Child Sexual Abuse Knowledge Inventory: May be copied as needed.

8. Abuse Prevention Policy: For your information. Copy as needed for counselors or others.

9. Report of Actual or Suspected Child Abuse or Neglect – Used to report to the State of Michigan.

10.  Written Reference Check – Use when sending reference questions to an individual.

11.  Criminal Background Check Directions – Directions for church background checks.

12. Outline of Abuse Prevention Policy for Certification of Volunteer Staff