Volunteer Reference Form — Powerful Schools

Name of Reference (Required)

Address (Required)

City (Required)

Zip Code (Required)

Email of Reference (Required)

Day Phone (Required)

Evening Phone (Required)

Volunteer Applicant Name (Required)

I have known the applicant for (months/years): (Required)

I know the applicant in the capacity of (friend, co-worker, other): (Required)

Have you ever seen this applicant work with children? (Required)

Do you have any concerns about the applicant working one-on-one with a child? If yes, please elaborate. (Required)

Reliability (Required)

1 2 3 4 5

Creativity (Required)

1 2 3 4 5

Enthusiasm (Required)

1 2 3 4 5

Ability to work well with people from other cultures (Required)

1 2 3 4 5

Please provide any additional information which may be relevant to this applicant becoming a Powerful Buddy. (Required)

To the best of my knowledge, the information provided above is accurate and true.