Volunteer Reference Form Volunteer Reference Form Applicant's Name * Applicant's Name First First Last Last ALL INFORMATION PROVIDED ON THIS FORM WILL BE CONSIDERED CONFIDENTIAL The individual named above is applying to volunteer as a reading tutor with Dyslexia Tutoring Program. Dyslexia Tutoring Program exists to identify, remediate, and provide advocacy and support services, without charge, to low-income children and adults with dyslexia and other language-based learning disabilities throughout Baltimore and surrounding communities. We do this by bringing volunteer tutors and clients together in an environment supportive of the learning process; and provide this service regardless of race, creed, gender, age, religious belief, or national origin. It will help us a great deal if you carefully answer the following questions to the best of your ability and knowledge. In what capacity have you known the applicant and for how long? * How would you describe the applicant's relationship with people in general? Please check all that apply. * Warm Shallow Loyal Shy Sincere Distant Unknown Do you have any reason to question this person's honesty or trustworthiness? * Yes (Please explain below) No I do not know this person well enough to respond. I wish to discuss the adverse information I have. Explanation * Please use the space provided to discuss your overall impression of the applicant and any additional information that would be helpful to us in evaluating the applicant. Thank you very much for taking time to complete this questionnaire. Reference Name * Reference Name First First Last Last Phone * Email * If you are human, leave this field blank. Submit
