Reference: Personal Reference Form

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.

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Your Name*
Please enter the name of the applicant you are providing a reference for.*
Did you know the applicant was applying to be a mentor?*
If No, please write N/A
Can the applicant be counted on to follow through on the commitments they undertake?*
Have you ever known the applicant to be inappropriate (emotionally, physically, verbally, sexually) with either adults or children?*
If No, please write N/A
To your knowledge, has the applicant ever had any trouble following rules?*
If No, please write N/A
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?*
Has the applicant experienced an addiction, health or emotional concern that may impact their ability to participate actively in a match?*
Would anything need to change in the applicant’s home environment to be suitable for a child’s visit?*
If No, please write N/A
Would you allow the applicant to develop a one-to-one relationship with your child or a child you care about?*
If Yes, please write N/A
Would you recommend the applicant as a mentor for a child or youth?*
Please confirm your full name*
Personal Verification*
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.