Personal Reference Form

* required information
Personal Reference 
Thank you for being a reference for a potential Big Brother or Big Sister. Please answer all questions honestly and completely as this is an important step in our screening process.
First Name:*
Last Name:*
Name of applicant you are providing a reference on:*
How long have you known this volunteer, in Years and Months?:*
In what capacity do you know this volunteer?:*
Describe their home environment, in particular how child friendly is it? Are there any safety concerns or any other concerns?:*
Can you tell me about a time you observed this volunteer around a child or 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 volunteer?:*
Do you know of any reason why this may not be the best time for this volunteer to commit to being a Big Brother or Big Sister?:*
What else would you like to tell us about this volunteer?:*
I am interested in learning more about spending 2 to 4 hours a week as a Big Brother, Big Sister or Big Couple.:* Yes
I am interested in supporting the goals and objectives of Big Brothers Big Sisters in other ways.:* Yes
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© 2010 Big Brothers Big Sisters of Greater Kansas City, 1709 Walnut Street, Kansas City, MO 64108, 816.561.5269