Teacher Reference

Provided for:*

Big Brothers Big Sisters is an organization that enrols volunteer mentors to provide a healthy role model to children and youth in our community. Volunteer mentors must provide a stable, positive influence over the period of their commitment, which is usually a school or calendar year. Many of the resilient children and youth in our programs have experienced challenges in their lives; relying on the consistent presence of a mentor makes a difference in their lives, likewise ending this important relationship sooner than expected can have a detrimental effect on the young person. Help us Start Something for our community’s youth by providing a reference that, to the best of your knowledge, is an honest reflection of the applicant and their ability to be a positive influence in the life of a child.

Your responses will remain confidential. Thank you.

1. How long have you known the applicant and in what capacity?*

Did you know the applicant was applying to be a mentor?*

Yes
No

If yes, what was your reaction?*

2. What personal strengths do you feel the applicant has to offer?*

Can the applicant be counted on to follow through on the commitments he/she undertakes?*

Yes
No

Please explain*

To your knowledge, has the applicant ever had any trouble following rules?*

Yes
No

If so, what kind of rules?*

3. Would you recommend the applicant as a mentor for a child or youth?*

Yes
No

4. Is there anything you would like to add that would aid us in our decision?*

Characteristics

Please rate the student on the following characteristics. Please provide a brief explanation if your answer reflects a "somewhat good", "poor" or "extremely poor" rating.

Flexibility*

Comments*

Ability to accept feedback*

Comments*

Maturity*

Comments*

Ability to manage time well*

Comments*

Ability to get along with others*

Comments*

Attentive*

Comments*

Ability to be on time*

Comments*

Ability to work unsupervised*

Comments*

Please provide the following for file purposes only (will not be used for promotional purposes)

Your Name*

Your Email*

Your Address*

Street Address Address Line 2 City Postal Code

Best phone number to reach you at*

That number is your:*

Cell
Work

Would you like us to contact you with information about how YOU can get involved?*

Yes
No

Today's Date

1-506-778-2444

contact@bgcmiramichi.com

506-778-2444

Teacher Reference

Big Brothers Big Sisters of Miramichi