Teen Mentor - Personal Reference Please answer the questions to the best of your ability. This information will be kept confidential. Step 1 of 5 20% Big Brothers Big Sisters embodies the principles of diversity and welcomes participation regardless of race, religion, culture or sexual orientation. Big Brothers Big Sisters is an organization that enrols volunteer mentors to provide a healthy role model to children and youth in our community. Volunteer mentors must provide a stable, positive influence over the period of their commitment, which is usually a school or calendar year. Many of the resilient children and youth in our programs have experienced challenges in their lives; relying on the consistent presence of a mentor makes a difference in their lives, likewise ending this important relationship sooner than expected can have a detrimental effect on the young person. Help us start something for our community’s youth by providing a reference that, to the best of your knowledge, is an honest reflection of the applicant and their ability to be a positive influence in the life of a child. Your responses will remain confidential. Thank you. Who is this reference provided for?(Required) Full NamePlease only continue with this reference form if you can confidently speak to this applicant’s character.Who is this reference provided by?(Required) Full NameAre you 19 years of age or older?(Required) Yes No The reference must be at least 19 years old. Please do not proceed with this reference form.Have you known the applicant for two or more years?(Required) Yes No The personal reference must have known the applicant for a minimum of two years. Please do not proceed with this reference form. Your phone number:(Required)Your email:(Required) Enter Email Confirm Email How long have you known the applicant?(Required) In what capacity?(Required)Did you know that this applicant was applying to become a mentor?(Required) Yes No If so, what was your reaction?(Required)What is it like to have this applicant as your friend?(Required)What personal strengths do you feel the applicant has to offer?(Required)Based on your knowledge of who the applicant has in their life, to whom would they be most likely to turn, or be most responsive to, for support or guidance?(Required)Can you tell me about the applicant’s community involvement and personal interests?(Required) Can the applicant be counted on to follow through on the commitments they undertake?(Required) Yes No Please explain:(Required)When have you witnessed the applicant interacting with children? How does the applicant interact with or relate to children?(Required)Have you ever known the applicant to be inappropriate (emotionally, physically, verbally, and sexually) with either adults or children?(Required) Yes No If so, please explain:(Required)To your knowledge, has the applicant ever had any trouble following rules?(Required) Yes No If so, what rules?(Required)Is there anything that you are aware of that may interfere with the applicant’s ability to mentor or that would cause their commitment to our organization to come to an end?(Required) Yes No Any comments?Has the applicant experienced an addiction, health or emotional concern that may impact their ability to participate actively in a match?(Required) Yes No Any comments?Would you allow the applicant to develop a one-to-one relationship with your child or a child you care about?(Required) Yes No If no, please explain:(Required)Would you recommend the applicant as a mentor for a child or youth?(Required) Yes No Please explain:(Required)Is there anything you would like to add that would aid us in our decision?By checking yes below, you're agreeing that all information given is true.(Required) Yes
