FCLA Volunteer Reference Form

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Reference Form

Please fill in the form below.
Who should complete this reference form?

This form should be completed by an adult who is not a family member and can speak to the volunteer’s character, responsibility, and ability to work with others.

Appropriate references may include:

Teacher, principal, mentor, tutor, Rabbi, coach, employer, program leader, or another non-family adult who knows the volunteer well.

References must be 18 years or older.
Volunteer Name

First NameLast Name
Your Name

First NameLast Name
Your Phone Number

Area CodePhone Number
Your Email Address
What is your relationship with the volunteer?
FORM MAY NOT BE FILLED OUT BY A RELATIVE

Please rate the volunteer on the following items:

Rows	Strongly Agree	Agree	Don't Know	Disagree	Strongly Disagree
The applicant is very responsible; able to make commitments and keep them.
This applicant shows a lot of tolerance and patience.
This applicant will be a valuable asset to our organization.
The applicant exhibits a high maturity level for their age.
The applicant is extremely suitable to work with children who have special needs.
The applicant has a very outgoing personality.

Is there any important information or concerns that we must be aware of?
Is there any other information you would like to share about why he/she would be a good fit for Friendship Circle? (optional)
Should be Empty: