Reference Form

Volunteer's Name:

Please answer the questions below.  We assure you that your answers will be held in confidence.

But first, here’s a little about our programs.

* Our Community-based program pairs a volunteer with a child, and the volunteer spends time with the child, based on the volunteer's schedule. On average, most volunteers see their "Little Brother" or "Little Sister" 2-3 times each month. Volunteers are encouraged to include the child in their normal activities, such as running errands, washing the car, renting movies, going to the mall, etc. Of course, going to the movies, ballgames, and out to eat, are also fun! A volunteer must be at least 19 years of age, and a minimum of one year is requested; however exceptions to the time commitment may be considered. * Our school-based program pairs a volunteer with a child in an elementary school and the volunteer will visit that child one-hour weekly during the school year. You can play games, help with homework, eat lunch or just spend time talking. A volunteer must be at least 16 years of age and a minimum of one school year is requested.

How long have you known the volunteer:

In what capacity do you know the volunteer: 

Can you tell us about a time when you observed the volunteer around a child or children?

What were your impressions or feeling about that interaction?

Do you know of any reason why being a Big Brother or Big Sister may not be the right volunteer experience for the volunteer?


Any additional information we should know?

Since this is an online form, one of our staff members will be in contact with you to verifiy that all of the information is correct. Please let us know how we may contact you. All fields must be completed. Thank You.

Your Name

Phone Number

Alternate Phone Number

Email address

Best time to contact you?

Once again thank you for taking the time to help ensure that the future of central Arkansas is bright!