Big Friend Reference Form

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Character Reference Form

Reference Name(Required)
Regarding BIG FRIEND Application(Required)

We are gathering the following information for the purpose of matching this applicant with a child. This character reference is confidential and the information you provide will be used by the FRIENDS administration only. It is IMPORTANT this character reference is completed and returned within FIVE (5) days, as the applicant cannot participate without it. During the application process, this applicant authorized the FRIENDS Program to contact you for this character reference.

The FRIENDS Program Overview

Friends is a supervised volunteer program designed to provide a close adult relationship for children identified as needing a special friendship by his/her elementary counselor and teachers. Community Adults, University or High School students are matched with elementary-age children and they become FRIENDS for at least one school year. The Adult Friend and Child Friend designate one hour a week for a one-on-one commitment. Involvement with family members other than the assigned Child Friend is discouraged. Each activity of the Adult Friend and Child Friend will be with parent/guardian knowledge and approval. Parent/guardian must give permission for acceptance of their child into the program and be present at the time the match is made. No match will be considered complete, nor any activity take place, until parent/guardian and Adult Friend meet and agree on the rules of the program and all character references have been reviewed. During the initial meeting, the parent/guardian will outline possible activity limitations and agree not to use time with the Adult Friend as a reward or withhold the program as a punishment, since participation in The FRIENDS Program is not considered a recreation, but education for living. Adult Friends are not expected to act as surrogate parents, nor to fulfill the duties of a parent in any way.
In your opinion, is this applicant of good moral character?(Required)
To your knowledge, has this applicant been convicted of a crime?(Required)
To your knowledge, has this applicant ever abused a child?(Required)
To your knowledge, has this applicant ever had a moving vehicle violation?(Required)
To your knowledge has this applicant ever had an alcohol or drug problem?(Required)

Please contact The Friends Program Director, Tammy Lawter, if you have questions related to the completion of this reference questionnaire. (phone 308-236-2036 or email