Accreditation Interview Form Form for use by State & Regional Leaders for interviewing new candidates Applicant's Name* First Last State*ACTNSWVICQLDWASATASNTDate of Interview* DD slash MM slash YYYY Method of Interview* Face to Face Video Conference Phone Call Names of any other participants Interviewer comments*Concerns raisedSuitable for* Associate Chaplain Recommendation* Highly Recommended Recommended Recommended with Reservations Not Recommended Code of Conduct Signed? Yes No Interviewer Name* First Last Interviewer Email* Δ