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Staff Reference Form

Our employees spend a lot of time with our campers and are responsible for their care. With this in mind, you have been chosen by the applicant to submit your comments on the applicant’s qualifications for this type of employment. The questions posed on this form are important to the Directors, who appreciate you answering them candidly. Please do not feel limited by the questions. Please cover any topic and add any statements that you feel relevant. The information you provide will remain confidential. Your prompt reply is much appreciated. Thank you for your assistance.

About the Applicant

Applicant's Name:
How long have you known the applicant?
In what capacity?
Would you re-hire this person?
If no, for what reason?
Is this the type of person you would want as a counselor for a child of your own?
Please rate the applicant in the following areas:
Dependability
Maturity
Cooperation
Leadership
Understands children
Enthusiasm
Social Acceptability
Responsibility
Humor
Patience
Flexibility
Communication
Overall
Assess the applicant’s ability to work in a group setting - is he/she a team player? Can he/she follow the rules?
What words or phrases immediately come to mind when describing the applicant?
Anything additional you would like to add about the candidate?

About You

Your Name:
Address:
City:
State:
Zip:
Phone:
Email: