Volunteer Reference - Personal KIMIKO Work in progress - High School /Junior High School mentors: Teen mentoring Program & Roots program - Adult mentors: Big Brothers, ISM Adult, Game On! and Mentoring with Math program Step 1 of 2 50% ConfidentialBig Brothers Big Sisters is an organization that enrolls 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 the reference provided For:* Full name of the applicant Is the applicant a school aged youth?* Yes No If this reference is for someone who is at the age between 14 to 18 and has applied to be a mentor in Teen Mentoring Program or Roots Program, please select Yes Who is the reference provided By:* Your Full Name Are you 19 years of age or older* Yes No Referees must be 19 years of age or older Please contact the person you are providing the reference for. Phone*Email* Enter Email Confirm Email Have you known the applicant for two or more years?* Yes No How long have you known the applicant?* And in what capacity?* Did you know the applicant was applying to be a mentor?* Yes No If so, what was your reaction?*What is it like to have the applicant as a friend?*What personal strengths do you feel the applicant has to offer?*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?*Can you tell me about the applicant’s community involvement and personal interests?*Can the applicant be counted on to follow through on the commitments they undertake?* Yes No Please explain:*When have you witnessed the applicant interacting with children? How does the applicant interact with or relate to children?*Have you ever known the applicant to be inappropriate (emotionally, physically, verbally, sexually) with either adults or children?* Yes No If so, please explain*To your knowledge, has the applicant ever had any trouble following rules?* Yes No If so, what kind of rules?*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?* Yes No If so, please explain.*Has the applicant experienced an addiction, health or emotional concern that may impact their ability to participate actively in a match?* Yes No If so, please explain.*Would anything need to change in the applicant’s home environment to be suitable for a child’s visit?* Yes No If so, please explain:*Would you allow the applicant to develop a one-to-one relationship with your child or a child you care about?* Yes No If not, please explain:*Would you recommend the applicant as a mentor for a child or youth?* Yes No Please explain:*Is there anything you would like to add that would aid us in our decision?By checking yes below, you agree that all the information above is true.* Yes
