Volunteer Reference Form

Name(Required)

First Last

Phone(Required)

Email(Required)

Applicant's Name(Required)

First Last

Prospective Volunteer Role(s):(Required)

How long have you known the applicant?(Required)

In what capacity?(Required)

How well do you know the applicant?(Required)

Very Well

Well

Fairly Well

Slightly

What would you consider to be the three greatest assets the applicant would bring to Blue Ridge Women’s Center?(Required)

How would you describe the way the applicant handles responsibilities?(Required)

Please check the statement that best expresses your thoughts about the applicant’s suitability to volunteer for the Blue Ridge Women’s Center:(Required)

This applicant receives my highest recommendation.

I recommend this applicant with confidence.

I recommend this applicant with some reservation.

I would not recommend this applicant to volunteer in this capacity.

Do you have any comments or concerns about this applicant that you would prefer to discuss in person?(Required)

Yes

No

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Blue Ridge Women’s Center is a 501(3)c nonprofit organization.

We do not provide or refer for abortions.

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540-362-3007

325 Elm Ave SE,
Roanoke, VA 24013

Mailing Address: PO Box 12261,
Roanoke, VA 24024

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