speech-bubbles-white

Reference form for family residents

Thanks for helping us learn a little more about this applicant! All of the information you supply on this form will be used solely in the resident application process and will be kept strictly confidential. Please complete and submit this form as soon as you can, but no later than June 19th.

Verification code (required)
This is the three-letter code provided in the email you received from MiCasa.

Name of applicant for whom you are providing this reference

Date

Your Name (required)

Your Email (required)

Length of time you've known this person

In what capacity do you know this person?

WorkPersonal

Please describe your relationship with the applicant

As a resident of Genesis, the applicant will act as a social support for their neighbors, including young families transitioning from foster care in DC, and will be required to commit 3-4 hours per week in support to the community.

Do you feel that the person you are supplying this reference for would be a positive role model, and fulfill the volunteer requirement?

Please explain your answer

Is there any other information you would like us to know about this applicant?

All of the information supplied on this form will be used solely in the application process of Genesis residents and will be kept strictly confidential. Please complete and submit this form as soon as possible, and no later than June 19.

If you have any questions, please contact:

Mi Casa
Email: info@micasa-inc.org
Tel: 202/722-7423

Icon made by Icomoon from www.flaticon.com is licensed under CC BY 3.0