Volunteer Online Reference

Potential Volunteer Name*
First Last
Date*
Date Format: MM slash DD slash YYYY
Person Submitting Reference:*
Your email address
How long have you known the applicant?*
In what capacity do you know the applicant?*
How well do you know the applicant?
Describe the applicant: Select as many that applies. (hold the "command" button as you select)*
Do you feel the applicant will hold to a one year commitment?*
Applicant's ability to work toward long term goals?
Applicant's reaction to people who are physically ill?
Applicant's reaction to people who are emotionally /mentally ill?
Applicant's adherence to basic rules?*
Is the applicant responsible?*
Is the applicant dependable?*
Is the applicant sensitive to others' needs?*
Is the applicant able to communicate well with others?*
Applicant's problem solving skills?*
Applicant's ability to handle stress or adverse situations?*
Applicant's time management skills?*
Do you know of any reason why the applicant would not serve well as a volunteer?*
Please add any further comments which you feel would assist us in considering the applicant for our program.
Please select from the following recommendations:*
Comments and additional information:
Would you like to receive additional information? (please hold "command" button as you select)
Please supply your mailing address if you wish to receive additional information by mail:
Your phone number

Potential volunteers are require to submit references before becoming a volunteer. Thank you in advance for giving this reference.

Compeer