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Personal Reference Form

Thank you for being a reference for a potential Mentor or Mentee. Please answer all questions honestly and completely as this is an important step in our screening process. Refer to the email that was sent to you to provide the mentor or mentee ID that you will need to put in the next box.

Mentor or mentee ID #*

Your name:*

Email Address*

How do you know the mentor or mentee?

If other please explain

How long have you known the mentor or mentee?

What can you tell us about her personality?

Do you believe that she possess good moral character?
Would you consider this person dependable?
Do you think that she would make a good mentor?


What else can you tell us about her ?*

Do you have any reservations about this woman volunteering to work with survivors of domestic violence? Why or why not?*

Thank you for completing this reference form. Your feedback is very important to to us. If we have further questions we will contact you directly.

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