Bothers 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.

  
Your Full Name*
 
 
 
Your Email*
 
 
Name of person who you are providing a reference for.
 
 
 
 
How long have you known the applicant and in what capacity?
 
 
Did you know the applicant was applying to be a mentor? If so, what was your reaction?
 
 
What personal strengths do you feel the applicant has to offer?
 
 
Has the applicant experienced an addiction, health or emotional concern that may impact his/her ability to participate actively in a match?
 
 
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?
 
 
When have you witnessed the applicant interacting with children?
 
 
How does the applicant interact with or relate to children?
 
 
To your knowledge, has the applicant ever had any trouble following rules? If so, what kind of rules?
 
 
Have you ever known the applicant to be inappropriate (emotionally, physically, verbally, sexually) with either adults or children? If so, please explain.
 
 
Would anything need to change in the applicant’s home environment to be suitable for a child’s visit?
 
 
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?
 
 
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?
 
 
Would you allow the applicant to develop a one-to-one relationship with your child or a child you care about? Why or why not?
 
 
Would you recommend the applicant as a mentor for a young person?
 
 
Is there anything you would like to add that would aid us in our decision?
 
 
Would you like to receive information about Big Brothers Big Sisters?
 
Yes
No
 
Email
 
 
 
 
 
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