Mentoring References

Fill out the form below to submit a Mentoring Reference

Your name has been given to us as a reference for a potential applicant in our mentoring program at Rise Up! We would appreciate you answering a few questions concerning the applicant. Your responses concerning him/her will be held in absolute confidence, and they will not be shared or accessible to him/her. Thank you so much for your time.
Applicant Name*
First Last
Date*
Date Format: MM slash DD slash YYYY
Your Name*
First Last
Your Phone Number*
Your Email*
How long and in what capacity have you known the applicant?*
How does the applicant relate to people in general?*
How would you describe the applicant?*
Do you feel that the applicant would be a good mentor and role model to a child?*
Do you think the applicant relates well to children and young people?*
Does the applicant usually keep his or her commitments?*
Is he or she on time for appointments and events?*
To your knowledge, has the applicant ever been convicted of a crime?*
Do you know of any problems or issues that would affect the applicant's ability to spend time alone with a child?*
Would you feel comfortable allowing the applicant to spend time alone with your child?*
Do you have any additional comments about the applicant?*
Have you ever thought about mentoring, and if so, can we send you some information?

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