Loudoun County Homepage Teen Volunteer Reference Form
* indicate required fields

This form is for you to provide reference for someone applying to the Teen Volunteer Program through the Loudoun County Department of Parks, Recreation and Community Services (PRCS). We ask that you respond to each of the following questions about the applicant's ability for volunteer work.

*Please state your full name.

*Please input the first and last name of the applicant that you are providing a reference for.
Former or current employeeFormer or current volunteerFriendOther
How do you know this applicant? Please note that a family member is not an acceptable reference source.* 

If you answered, "other" to the previous question, please explain how you know the applicant.

*How long have you known this applicant?
1 - Poor2 - Between poor and good3 - Good4 - Between good and excellent5 - Excellent
How do you rate the applicant's communication skills? (Their ability to express themselves clearly and concisely)* 
How do you rate the applicant's listening skills?* 
How do you rate the applicant's people skills? (Ability to exhibit warmth, empathy and patience)* 
How do you rate the applicant's dependability and reliability?* 
How do you rate the applicant's trustworthiness?* 
How do you rate the applicant's flexibility?* 

*Please enter your email address for quality assurance.

Please click the submit button below to complete this reference form. Thank you for helping the Teen Volunteer Program.