Family Reference
 

Boys and Girls Club Big Brothers Big Sisters of Edmonton is an organization that enrolls 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.

 
 
 
Name of person who you are providing a reference for?*
 
 
 
Your Name*
 
 
Best Contact phone number?*
 
 
Your Email:*
 
 
Email
 
 
 
 
 
1. How long have you known the applicant and in what capacity?*
 
 
 
2. Did you know the applicant was applying to be a mentor? What was your reaction?*
 
 
 
3. What personal strengths do you feel the applicant has to offer?*
 
 
 
4. Can you tell me about the applicants community involvement and personal interests?*
 
 
 
5. When have you witnessed the applicant interacting with children? How do they interact with or relate to children?*
 
 
 
6. Can the applicant be counted on to follow through on the commitments they undertake? Please Explain.*
 
 
 
7. Based on your knowledge of who the applicant has in their life, who would they be most likely to turn, or be responsive to for support or guidance?*
 
 
 
8. To your knowledge, has the applicant ever had any trouble following rules? If so, what kind of rules?*
 
 
 
9. Have you ever known the applicant to be inappropriate (emotionally, physically, verbally and sexually) with either adults or children? Please Explain?*
 
 
 
10. Would anything need to change in the applicants home environment to be suitable for a child's visit? Please Explain?*
 
 
 
11. Is there anything that you are aware of that may interfere with the applicants ability to mentor or that would cause their commitment to our organization to come to an end?*
 
 
 
12. Has the applicant experienced an addiction, health or emotional concern that may impact their ability to participate actively in a match?*
 
 
 
13. Would you allow the applicant to develop a one to one relationship with your child or a child you care about? If Not, Why?*
 
 
 
14. Would you recommend the applicant as a mentor for a child or youth?*
 
 
 
15. Is there anything you would like to add that would aid us in our decision?*
 
 
 
Date*
 
 
 
 
Thank you so much for completing the required family reference!  Should you have any questions or concerns, please don't hesitate to contact us @ 780-424-8181.