If you have questions please email the Program Director or call our camp office (contact info at bottom of page).

If you prefer, print a hard copy to mail in. (Adobe Acrobat .pdf file)

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Confidential Reference Form-for Staff-in-Training Applicants

Reference cannot be filled out by a relative. This information will not be shared with the applicant.


Name of Applicant

Please answer the following questions to the best of your knowledge of the applicant. Thank you.
1. How long have you known this person?		In what capacity?
2. How do you know this person

3. Select appropriate number:	-- poor --		----- average -----			----- good -----			-- superior --
Teachable	1	2	3	4	5	6	7	8	9	10
Promptness	1	2	3	4	5	6	7	8	9	10
Follows Instructions	1	2	3	4	5	6	7	8	9	10
Outgoing / Energetic	1	2	3	4	5	6	7	8	9	10
Emotional Balance	1	2	3	4	5	6	7	8	9	10
Capacity To Work With Infants	1	2	3	4	5	6	7	8	9	10
Capacity To Work With Children	1	2	3	4	5	6	7	8	9	10
Capacity To Work With Youth	1	2	3	4	5	6	7	8	9	10
Capacity To Work In Group	1	2	3	4	5	6	7	8	9	10
Capacity To Work With Peers	1	2	3	4	5	6	7	8	9	10
Fulfills Obligations	1	2	3	4	5	6	7	8	9	10
Sense Of Humor	1	2	3	4	5	6	7	8	9	10
Temper Control	1	2	3	4	5	6	7	8	9	10
Follow-Through Ability	1	2	3	4	5	6	7	8	9	10
Social Skills	1	2	3	4	5	6	7	8	9	10
Trustworthy	1	2	3	4	5	6	7	8	9	10
Gets Along With Others	1	2	3	4	5	6	7	8	9	10
Tact (discretion with words)	1	2	3	4	5	6	7	8	9	10
Leadership Ability	1	2	3	4	5	6	7	8	9	10
Friendly	1	2	3	4	5	6	7	8	9	10
Moral Reputation On Campus	1	2	3	4	5	6	7	8	9	10

4. Please Comment on the applicant's spiritual life:
5. Would you completely trust this individual to guide and care for your child in a one-on-one or group setting? Please explain if hesitant.
6. To your best knowledge, has this applicant ever been expelled or suspended from school or employment or charged with, arrested for or convicted of any offense or violation of any stature or law? Yes No
7. I would . What specific reason would you give for accepting or not accepting the applicant?
8. I expect the applicant's work to be:
9. Contact Information