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Volunteer Reference Form

Your name has been submitted as a character reference for someone applying to become a Big Brother or Big Sister.

Big Brothers and Big Sisters are adult volunteers who provide companionship, support and guidance on a one-to-one basis to children between the ages of 6 and 13 who live in one-parent or non-traditional homes.
A volunteer is expected to spend 2-4 hours per week with a child for at least 12 months.
Volunteers must be mature, responsible, individuals who have the ability to relate to and work well with children.
The information you provide will help us determine this applicant's ability to be a good Big Brother or Big Sister. All the information you provide will be kept confidential.
If you have any questions, or would like to complete this questionnaire over the phone instead of in writing, please feel free to contact our office at 815/723-2227.

With this information in mind, please provide detailed answers to the following:

Your Full Name
Your Area Code & Phone # (in case we have follow-up questions)
Your Email Address (in case we have follow-up questions)
Applicant's Name
How long have you known the volunteer applicant? (in years & months)
In what capacity do you know the volunteer applicant?
Please describe the applicant's ability to make and keep relationships and friendships.
Please describe their home environment, in particular how child friendly it is? Would you feel comfortable letting your child or a child you care about spend time in the applicant's home?
Please tell us about a time you observed the applicant around children.
What were your impressions or feelings about that interaction?
Do you know of any reason why being a Big Brother or Big Sister may NOT be the right volunteer experience for this applicant? Please explain.
Do you know of any reason why this may NOT be the best time for this applicant to commit to being a Big Brother or Big Sister? Please explain.
To the best of your knowledge, has the applicant ever been arrested? If yes, please explain.
To the best of your knowledge, has the applicant ever experienced drug or alcohol related problems? If yes, please explain.
To the best of your knowledge, has the applicant ever been involved in child molestation or a sexual relationship with a minor? If yes, please explain.
To the best of your knowledge has the applicant ever been hospitalized for an emotional/mental concern? If yes, please explain.
What else would you like to tell us about this volunteer?