Reference Consent Form

This document is required if you are applying to the Next Step program.

 

  • Reference Check Consent Form and Release

    Please provide five references in the boxes below. Provide at least one person in each category.
  • Employer NameCityStateContact PersonStart and End DatesEmployer Phone 
    To add more lines, click on the + in the circle at the end of the line.
  • NameCityStatePhone NumberStart and End Dates 
    To add more lines, click on the + in the circle at the end of the line.
  • NameRelationshipCityStatePhone Number 
    To add more lines, click on the + in the circle at the end of the line.
  • This is a legally binding signature that grants Bethel permission to check your references.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.