reference Entry

Added: 7/26/2024

Kids Hope USA

Reference

All information will be kept confidential.

The applicant listed below has applied to be a Kids Hope USA mentor for our church. A Kids Hope USA mentor meets with one elementary age student, one hour a week virtually or at school, to build a positive, trustworthy relationship. In order to help us determine the suitability of this applicant for this position, we are asking that you take a few moments to respond to these questions.

Applicant

Applicant First Name

Applicant Last Name

Your Information

Your First Name

Your Last Name

Your Phone Number

How long have you know this applicant?

What is your relationship to the applicant?

Your Reference

Have you seen the applicant working with children or students firsthand?

No Yes

Can you give an example of how the applicant relates to children?

How would you rate the applicant's ability to be genuinely supportive, encouraging, and understanding to the needs of a child?

Above satisfactory Satisfactory Below satisfactory

How would you rate the applicant's ability to be patient and stay calm?

Above satisfactory Satisfactory Below satisfactory

Have you ever observed the applicant using harsh or demeaning language toward a child?

Does the applicant pose a danger to the well-being of the child he or she would be mentoring?

Would you be comfortable placing one of your own children or grandchildren in the care of the applicant? Why or why not?

Do you have any additional comments or questions?

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Date

Thank you for your time completing this Reference form.

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Kids Hope USA

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