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Potential Mentor Reference
The following individual has applied to be a volunteer mentor with Tarheel ChalleNGe Academy. He/she is being considered for a match in a one-to-one relationship with one of our cadets. The information received by you is kept in strict confidence.
Potential Mentor Name
*
How long have you known the applicant
*
In what capacity?
*
Does the applicant work well with others?
*
Yes
No
Does the applicant have a good home relationship?
*
Yes
No
Does he/she have a tendency to over-commit or get too involved?
*
Yes
No
Please rate the volunteer on the questions below:
*
Excellent
Average
Poor
Compassion for those in need
Excellent
Average
Poor
Concern for young people
Excellent
Average
Poor
Maturity and stability
Excellent
Average
Poor
Ability to respect others with differing views and values from their own
Excellent
Average
Poor
Skillfulness to express an opinion in the face of opposition
Excellent
Average
Poor
Responsibility to use confidential information appropriately
Excellent
Average
Poor
Ability to remain objective in a crisis or conflict situation
Excellent
Average
Poor
Capability to problem solve and reach decisions independently
Excellent
Average
Poor
Openness to learning
Excellent
Average
Poor
Verbal communication skills
Excellent
Average
Poor
Written communication skills
Excellent
Average
Poor
Proficiency to carry out assignments in due time
Excellent
Average
Poor
Do you have any concerns about the suitability of the application or their ability to work with our cadets?
Name
*
Reference Email Address
*
Date
*
+
Phone Number
*
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