Volunteer Reference Form

Questions that require an answer are marked with  *
   
1 * What is the name of the volunteer applicant for whom you are completing this form?
   
   
2 * What is your name?
   
   
3 * In what capacity have you known the applicant?
   
Other:
   
4 * Would you recommend this applicant for a volunteer position with our organization?
   
   
5 Why or why not?
   
   
6 Do you know of anything that might limit this applicant's ability to volunteer at or for the Association?
   
   
7 * Please rate the following categories as they pertain to your current knowledge of this applicant.
   
 No basis to knowBelow averageAverageGoodVery goodExcellent (Top 10%)
Demonstrates integrity
Assumes responsibility for actions
Polite and considerate of others
Demonstrates critical thinking and problem solving skills
Demonstrates effective verbal skills
Able to manage multiple responsibilities simultaneously
Determined and persistent in challenging situations
Demonstrates follow through
Dependable and reliable
Able to follow rules and advocate for others to do the same
Demonstrates flexibility
Accepting of diverse populations and events
Values individual's perspectives and potential
   
8 Do you have any additional information you would like to share about the applicant?
   
     

© Histiocytosis Association

332 North Broadway, Pitman, New Jersey  08071 USA
Phone: +1 856-589-6606 | Fax: +1 856-589-6614 | info@histio.org
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