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Membership Reference Form

Reference Information

Name of Reference:
Address:
City, State, Zip:
,
Telephone:
Example: 999-555-1234
Reference's E-Mail Address:
Reference CAC Membership Status:
Affiliate
Associate
Full
Life
   

Applicant Information

Applicant Name:
Applicant Agency:
   
Please describe your relationship to the applicant:
  Supervisor
Coworker
Other

How long have you known the Applicant?

To your knowledge, is the applicant:
Yes
No
Don't Know
currently engaged in forensic work?
professional competent?
of good character?

If known, where is the applicant employed and what type of forensic work is the applicant doing?:
 
 
If you have not personally worked with the applicant, please list other CAC members with whom the applicant has been associated.:
 
   
Do you, without qualification, recommend the applicant for membership in the CAC?:
  Yes
No
Not qualified to give opinion
   
If no, please state reasons/reservations below:
 
   
I certify that I am the reference listed above, and that all the information submitted on this form is true and correct to the best of my knowledge.