Vulnerable Sector Reference Reference Name* Reference for...* How long have you known the applicant and in what capacity? Did the applicant report directly to you? Yes No What was the applicant's role in your organization? How long did the applicant volunteer? Did the applicant take on more responsibility or additional roles as time passed? Yes No Did the applicant receive support and/or training? Why did the applicant resign their volunteer role? Did you know the application was applying to be a mentor? Yes No If so, what was your reaction? What personal strengths do you feel the applicant has to offer?Based on your knowledge of the applicant, to whom would he/she turn to for support or gudiance? Can the applicant be counted on to follow through on the commitments he/she undertakes? Yes No Have you ever known the applicant to be inappropriate (emotionally, physically, verbally, sexually) with either adults or children? Yes No If so, please explain: To your knowledge, has the applicant ever had any trouble following the rules? Yes No If so, what kind of rules? Are you aware of any complaints being made or disciplinary actions being taken against the applicant? Yes No Would you recommend the applicant as a mentor for a child or youth? Yes No Is there anything else you would like to add that would aid us in our decision?CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. Facebook Twitter Google+ LinkedIn
