RJH - Volunteer Applicant Reference Check

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1. What is the name of the volunteer applicant you are supplying the reference to?

What is the name of the volunteer applicant you are supplying the reference to?

2. For High School Students Only: What grade is the applicant currently enrolled in?

For High School Students Only: What grade is the applicant currently enrolled in?   Grade 8 Grade 9 Grade 10 Grade 11 Grade 12

3. For High School Students Only: Is the applicant enrolled in any specialized classes?

For High School Students Only: Is the applicant enrolled in any specialized classes?   Gifted Challenge Sports Related Special Education Distance Education Home Schooled

*

4. What is your name? (first and last)

What is your name? (first and last)

5. What is your email address or telephone number?

What is your email address or telephone number?

*

6. How long have you known the applicant, approximately?

How long have you known the applicant, approximately?   Less than 1 year 1 - 3 years 4 - 5 years More than 5 years

7. What has been the nature of your relationship?

What has been the nature of your relationship?   Friends Neighbours Colleagues I was his/her employer I was his/her employee

Other (please specify)

8. We are looking for volunteers who:
- are outgoing
- are compassionate
- are non-judgemental
- can maintain confidentiality
- demonstrate initiative
- are reliable
- follow policies and procedures

Do you think the applicant will be a good fit with the above qualities?

We are looking for volunteers who: - are outgoing - are compassionate - are non-judgemental - can maintain confidentiality - demonstrate initiative - are reliable - follow policies and procedures Do you think the applicant will be a good fit with the above qualities?   Yes No

Not sure or maybe (please specify)

9. What are the candidate's three strongest qualities?

What are the candidate's three strongest qualities?

10. Is the applicant a team player or does he/she excel by working alone?

Is the applicant a team player or does he/she excel by working alone?   Works best alone Works best with a group Works well with both Not sure

11. Please check the box on each line that best describes the applicant:

	Don't know	Outstanding	Very Good	Good	Needs Improvement
Sensitive to people & their problems	*Please check the box on each line that best describes the applicant: Sensitive to people & their problems Don't know	Sensitive to people & their problems Outstanding	Sensitive to people & their problems Very Good	Sensitive to people & their problems Good	Sensitive to people & their problems Needs Improvement
Able to discuss thoughts and feelings	Able to discuss thoughts and feelings Don't know	Able to discuss thoughts and feelings Outstanding	Able to discuss thoughts and feelings Very Good	Able to discuss thoughts and feelings Good	Able to discuss thoughts and feelings Needs Improvement
Able to talk to others about their feelings	Able to talk to others about their feelings Don't know	Able to talk to others about their feelings Outstanding	Able to talk to others about their feelings Very Good	Able to talk to others about their feelings Good	Able to talk to others about their feelings Needs Improvement
Communicates well with fellow workers	Communicates well with fellow workers Don't know	Communicates well with fellow workers Outstanding	Communicates well with fellow workers Very Good	Communicates well with fellow workers Good	Communicates well with fellow workers Needs Improvement
Communicates well with friends	Communicates well with friends Don't know	Communicates well with friends Outstanding	Communicates well with friends Very Good	Communicates well with friends Good	Communicates well with friends Needs Improvement
Treats others honestly and respectfully	Treats others honestly and respectfully Don't know	Treats others honestly and respectfully Outstanding	Treats others honestly and respectfully Very Good	Treats others honestly and respectfully Good	Treats others honestly and respectfully Needs Improvement
Has good common sense	Has good common sense Don't know	Has good common sense Outstanding	Has good common sense Very Good	Has good common sense Good	Has good common sense Needs Improvement
Does not judge people	Does not judge people Don't know	Does not judge people Outstanding	Does not judge people Very Good	Does not judge people Good	Does not judge people Needs Improvement
Welcomes growth and change	Welcomes growth and change Don't know	Welcomes growth and change Outstanding	Welcomes growth and change Very Good	Welcomes growth and change Good	Welcomes growth and change Needs Improvement
Uses free time constructively	Uses free time constructively Don't know	Uses free time constructively Outstanding	Uses free time constructively Very Good	Uses free time constructively Good	Uses free time constructively Needs Improvement
Able to learn and follow directions	Able to learn and follow directions Don't know	Able to learn and follow directions Outstanding	Able to learn and follow directions Very Good	Able to learn and follow directions Good	Able to learn and follow directions Needs Improvement
Able to take suggestions/criticism	Able to take suggestions/criticism Don't know	Able to take suggestions/criticism Outstanding	Able to take suggestions/criticism Very Good	Able to take suggestions/criticism Good	Able to take suggestions/criticism Needs Improvement
Able to work closely with others	Able to work closely with others Don't know	Able to work closely with others Outstanding	Able to work closely with others Very Good	Able to work closely with others Good	Able to work closely with others Needs Improvement
Able to take initiative	Able to take initiative Don't know	Able to take initiative Outstanding	Able to take initiative Very Good	Able to take initiative Good	Able to take initiative Needs Improvement
Is Reliable	Is Reliable Don't know	Is Reliable Outstanding	Is Reliable Very Good	Is Reliable Good	Is Reliable Needs Improvement

12. To the best of your knowledge, is the applicant honest?

To the best of your knowledge, is the applicant honest?   Don't know Yes

No (please specify)

13. If you were in a position to, would you hire/rehire this person?

If you were in a position to, would you hire/rehire this person?   Not sure Yes

No (please specify)

14. Is there anything that hasn't been asked about the applicant that you think is important to share in order to help us determine his/her suitability to volunteer at the Hospital?

Is there anything that hasn't been asked about the applicant that you think is important to share in order to help us determine his/her suitability to volunteer at the Hospital?