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Volunteer Reference Check Form

Volunteer Reference Check

Your name has been provided to us as a reference by someone who is interested in volunteering at our organization.  Please take a moment to complete the following questionnaire to assist us in learning more about this applicant.  Thank you kindly for your assistance.  If you have any questions, please feel free to contact us at volunteer@mccormickcare.ca.

Please note that all fields with an asterisk * are required.

* Volunteer Name

* Your Name

* Email

* Your Phone

* Today's Date


* How do you know this person?

* Do you feel this individual is reliable and able to fulfill a commitment as a volunteer on a regular basis?
yesno

Please elaborate on your answer:

* What skills/qualities do you feel this individual has that would be of value in their volunteer position with our organization?

* Do you have any concerns about this individual's performance, such as unreliability or confidentiality?
yesno

Please elaborate on your answer:

* Would you recommend this individual to work with us at McCormick Home and McCormick Dementia Services?
If you prefer to speak with us directly, please contact Sue Cason, Life Enrichment and Volunteer Co-ordinator, at 519-435-2648 ext.2372

yesno

Please elaborate on your answer:

Is there anything else you would like to tell us about this individual?

[recaptcha]

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