Online REFERENCE Form

The Gateway Vincentian Volunteers provides an opportunity for young men and women to participate in a year of volunteer service working with the poor in the city of St. Louis and surrounding areas. Our mission is to provide young adults with an experience of of living in community and working with the poor in the spirit of Saint Vincent DePaul, whose life's work was dedicated to serving the poor and needy. It is our goal that by working, praying, and living in the spirit of Vincent, these young adults will develop a consuming commitment to improving the lives of the poor and marginalized in our society. We are looking for young adults who you believe would be excited about our mission.

Your information is very important for the application process so please return as quickly as possible. Skip any question you feel unqualified to answer.

*** If using the Save For Later feature, the application must be completed

on the same computer and within 31 days. ***

Name of Applicant:
Reference Name:
Street Address:
City:
State:
Zip Code:
Email:
Phone:
May we contact you by phone?	Yes No
Your Occupation:

1. How long have you known the applicant and what is the basis of your relationship?

2. List three words that describe the applicant:

3. What do you think is motivating her/him to apply for volunteer service?

4. What are some of the applicant's strengths?

5. In what areas does the applicant need to grow?

6. How does the applicant handle conflict?

7. How does the applicant show genuine concern for others?

8. Give an example of the way the applicant gets things done.

9. Does the applicant function better in a highly structured situation or one which allows for flexibility and personal initiative?

Enter the number below which best describes your overall rating of the applicant.

1: Weak, Needs Help
2: Satisfactory
3: Good
4: Very Good
5: Outstanding

	Flexibility		Common sense
	Willingness to serve others		Openness to different expressions of faith
	Ability to be a team player		Ability to work with others
	Emotional maturity		Sense of humor
	Sense of responsibility		Leadership ability
	Creativity

Please type the characters you see in the above box into the field below.

A value is required.Invalid format.

AGREEMENT

I certify that to the best of my knowledge, all information contained in this application is true and complete.
I further understand that any material misrepresentation or falsification may be sufficient grounds to refuse admission into or removal from the Gateway Vincentian Volunteers. If submitting this form on-line please initial following box to attest to the previous agreement statement.

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Gateway Vincentian Volunteers
2912 Arsenal Street
St. Louis, MO 63118
(314) - 771-1474
Toll free: (888)-771-7220
Fax: (314) - 771-2410
email: gatevol@aol.com