Volunteer Reference Form
Please complete the following to the best of your ability. Your information and answers will not be shared with any other parties.
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Email
*
example@example.com
Name of person you are providing a reference for:
*
First Name
Last Name
Length of time you have known the applicant?
*
In what capacity do you know the applicant?
*
Describe the applicant's relationship to people, in general.
*
How would you rate the applicant's ability to judge interpersonal relations?
*
Excellent
Good
Average
Poor
Please give one example.
*
Please rate the applicant in the following areas
*
Excellant
Good
Average
Poor
Ability to cooperate with others?
Trustworthiness?
Dependability?
Self-confidence?
Verbal Communication skills?
Written Communication Skills?
Check ALL of the following which describe the applicant:
Please describe a stressful situation that illustrates how the applicant approached and resolved the situation. Please be specific.
*
Do you feel the applicant is in a position to make a commitment of at least one year?
*
Yes
No
Referring to ONLY the previous question, Why do you feel this way about the applicant?
*
To your knowledge, has the applicant ever abused the use of drugs or alcohol?
*
Yes
No
Based on your understanding of our program, would you recommend this applicant as a CASA advocate?
*
Yes
No
Referring to ONLY the previous question, Why do you feel this way about the applicant?
*
Please provide any additional information that would help us evaluate this applicant.
Signature
*
Email
example@example.com
Submit
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