Personal Reference Form - Big Brothers Big Sisters Kansas City

Someone you know is applying to become a Big Brother/Sister and has given us your name as a reference. Your responses to the following questions will be kept confidential and will be used by our staff to decide whether to accept his/her as a Big Brother/Sister and, if accepted, to help us determine which child would be a good match for him/her.

Big Brothers Big Sisters Kansas City is a mentoring program that is committed to making a life-changing, generational impact on our community through creating professionally supported, one-to-one Matches between caring adults and kids in KC that empower children to realize their full potential.

Your Contact Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Reference Information

Name of applicant you are providing a reference on(Required)

How do you know the applicant?

How long have you known the applicant?

How well do you feel you know the applicant?(Required)

How would you describe the applicant’s personality?(Required)

Tell me about the applicant’s general strengths and weaknesses.(Required)

Have you had the opportunity to observe the applicant around children? If so, how would you say the applicant relates to children?(Required)

How well do you think the applicant would interact with youth from a background different than their own?(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)

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)

Do you consider this applicant dependable?(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? Do you have any concerns about whether or not this may be the right time for them to volunteer as a Big Brother or Sister?

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