Pair Program Recommender Form

The form below is for recommenders of Pair Program volunteer applicants. Recommenders should be an adult who knows the applicant well and can objectively assess his or her character and maturity. Recommenders do not need to know applicants in an academic or professional setting. Examples of recommenders include a teacher, advisor, activity supervisor, coach, family friend, or anyone else of your choosing.

Recommenders: please fill out the form below or e-mail your recommendation (including the full name of the applicant) to Thank you!

Personal Info

Your Name*


Cell Number*

Home Phone

Applicant Info

Name of Pair Program Applicant*

Relationship to Applicant:

Please honestly and fully assess the applicant’s maturity and character. To what extent do you trust the applicant? How sensitive is the applicant to others’ feelings and emotions? What is the applicant’s personality like? Would the applicant be a good candidate for a program that pairs him/her with a patient who has been diagnosed with a life-threatening illness? There are no minimum or maximum word requirements, but we recommend three to five paragraphs.*

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