Reference

Please complete the following questions to accompany the Camp Illahee staff application. We appreciate your thoughtful and honest consideration of the applicant!

Applicant's Name

How long have you known the applicant and in what capacity?

If employer, is applicant eligible for rehire?

Would you employ applicant in a position working directly with children?

What are the applicant's most significant strengths?

If hired, in what areas do you think the applicant has room for improvement?

Please check the rating which best describes the applicant’s ability in each area, with 5 = Superior, 1 = Poor. All information you provide will remain confidential.

Self Esteem

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Patience

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Energy/Enthusiasm

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Sound Judgement

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Sense of Values

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Flexibility

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Reliability/Punctuality

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Initiative

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Concern for Others

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Emotional Maturity

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Receptiveness to Constructive Criticism/Feedback

Five – Superior
Four
Three – Average
Two
One – Poor
No opportunity to observe

Comment

Comment on how you would feel with the applicant caring for YOUR child.

Please feel free to add additional comments about the applicant.

Name

First Last

Phone

Email

Date

Staff Reference Form