Employer Reference Form Employer Reference Questionnaire Someone you know is applying to become a Big Brother/Sister and has given us your name as a reference. They have signed a release permitting you to disclose information in order to complete this reference. Your responses to the following questions will help us determine volunteer’s fit, including the applicant’s suitability to be matched with a child in the Big Brothers Big Sisters program, and help to facilitate a successful match as part of a comprehensive enrollment process. Your responses will be kept confidential. Big Brothers Big Sisters is a mentoring program serving children who face adversity, providing caring one-to-one volunteer mentors who meet with a child in the community.Your InformationName(Required) First Last Email(Required) Phone(Required)Reference InformationName of applicant you are providing a reference on(Required)In what capacity do you know the applicant?(Required)How long have you known the applicant?(Required)QuestionsAre/were you the applicant’s direct supervisor?(Required)Describe the applicant’s responsibilities in their position as an employee with your company/organization?(Required)How would you describe the applicant’s personality?(Required)Tell me about the applicant’s general strengths and weaknesses.(Required)Can you describe a time when the applicant was in a situation where they displayed adaptability and/or flexibility?(Required)Do you consider this applicant dependable?(Required)Part of the role of being a Big requires monthly check-ins to touch base on the Match and offer support. How does the applicant do with feedback and coaching?(Required)How does the applicant get along with others?(Required)Have you had the opportunity to observe the applicant around children? If so, how would you say the applicant relates to children?(Required)Have you ever observed the applicant disciplining a child? If so, please describe what you observed.(Required)Have you ever had any reason to be concerned about the applicant’s interaction with children? Please explain.(Required)Have you had the opportunity to see the volunteer’s home environment? If so please describe the volunteer’s home environment and neighborhood, and list any concerns you may have regarding a child visiting the applicant’s home.(Required)Do you have any concern about whether or not this is an appropriate volunteer assignment for this individual, or may not be the right time for them to volunteer as a Big Brother or Sister? *(Required)On a scale of 1-10 how strongly would you recommend this applicant for this volunteer position? Why did you give that rating?(Required)Is there anything further you’d like to tell us about this applicant?(Required)Thank you for serving as a reference for this applicant. Would you like more information about how to become involved as a volunteer or financial supporter of Big Brothers Big Sisters Kansas City? * Yes No
