Volunteer Counsellor Reference Form

The person we have email you about has expressed an interest in being a volunteer counsellor for the Nightingale Cancer Support Centre and has given your name as a referee. If you are happy to complete this reference, all the information contained on the form will remain confidential within the organisation. However, the named person may at some stage exercise his/her right to access this information.

We would appreciate you being extremely candid in your evaluation of this person.

Name of Volunteer Applicant*
How long have you known this person?*
In what capacity do you know this person?*
How would you descibe their personality*
What qualities, experience and qualifications does this person have which would make them suitable as a Volunteer Counsellor?*
Please comment on this person's ability to communicate with and develop relationships with other people*
Please give any other information which you feel may be relevant*
Referee Signature
By signing below you confirm that the information provided in this reference is true and complete to the best of your knowledge, and understand that if it is subsequently discovered that any statement is false or misleading or that you have concealed any relevant facts, the applicants applications may be withdrawn.
Name*
Email
Signature*
CAPTCHA
Privacy policy*
- I have read the privacy policy that explains how my information may be used

Volunteer Counsellor Reference Form

Referee Signature