Heart of the City 2019-20 Reference Form

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Thank you for agreeing to be the reference for the candidate's application to volunteer with the Heart of the City Music Program (HCMP). HCMP is a University of Alberta student group operating in collaboration with the Edmonton Public School Board (EPSB), the Edmonton Catholic School District (ECSD) and the Norwood Child & Family Resource Centre (NCFRC). For the year of 2019-20, our volunteers will teach piano to children at one of the inner-city elementary schools. Volunteers travel to their respective schools and teach 2 students, for a total of 1-2 hours a week. We want our volunteers to serve as positive role models, so it is important that they are responsible, reliable, and enthusiastic. In addition to a Police Check, we require one reference to be completed for every volunteer.

The candidate has chosen you to be his/her reference. Please answer the questions honestly and include any further comments regarding the candidate's suitability for the program. By completing and signing this form, you are agreeing to be contacted for further information (if necessary) and verifying that you are not a family member or close friend.

If you have any problems or questions while filling out the form, please contact us at hcmp.edmonton@gmail.com

Candidate's Full Name *

Reference Information

Full Name *

Phone Number *

Email Address *

How long have you known the candidate for? *

In what capacity do you know the candidate? *

Please rate the following items on a scale from 1 to 5

(1 = Strongly Disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly Agree)

The above candidate possesses the patience to work with children. *

Strongly Disagree

Strongly Agree

I would trust the above candidate to interact with inner-city elementary school children. *

Strongly Disagree

Strongly Agree

The above candidate has demonstrated that he/she is responsible. *

Strongly Disagree

Strongly Agree

The above candidate is consistently reliable and punctual. *

Strongly Disagree

Strongly Agree

The above candidate is willing and capable of taking initiative. *

Strongly Disagree

Strongly Agree

From my experience, the above candidate is motivated and has shown strong commitment and dedication to his/her activities. *

Strongly Disagree

Strongly Agree

I believe that the above candidate would be an excellent teacher. *

Strongly Disagree

Strongly Agree

I believe that the above candidate would make a positive role model. *

Strongly Disagree

Strongly Agree

I recommend the above candidate to the Heart of the City Music Program. *

Strongly Disagree

Strongly Agree

Questions

What are some of the qualities and strengths that the candidate possesses that would make him/her an excellent volunteer for the HCMP? *

Have you observed the candidate interacting with children before? Please describe the situation and your impression. *

Is there anything else you would like to tell us about the candidate?

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