Reference Form for Junior Volunteer Applicants

Use this form to provide a reference for a person applying to the junior volunteer program at UVA Health System. Your reference helps us decide whether to accept this applicant as a junior volunteer. Please rate this candidate in each of the following categories and answer the two questions below. We will not share your responses with the applicant.
Applicant Rating
Fulfills Commitments
Attendance
Relates to Diverse Populations
Emotional Maturity
Verbal Communication
Takes Initiative
Courtesy/Politeness
Follows Instructions
Manages Stressful Situations
Enthusiastic
Dependable
Provide an example of an occasion where the applicant used interpersonal communication skills to deal with a difficult or stressful person or situation.
Does the applicant have any notable skills to contribute while in the role of junior volunteer?
Not all teens are outstanding in every area. Given the number of teens you interact with, please indicate where this applicant falls in each of the areas above. (For instance, the top 10% of this age group might get “Excellent.”)
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