NAME OF APPLICANT:
REFERENCE'S INFORMATION
Name:
Address:
City/State/Zip:
Phone #:
Email Address:

APPLICANT'S INFORMATION

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


If as an employer, would you re-hire the Applicant? If no, please explain.


In your opinion, is the Applicant physically able to carry out an active and strenuous job for 16 hours a day? If not, please explain.

EVALUATE THE APPLICANT'S CHARACTER (1: Excellent, 2: Good, 3: Average, 4: Fair, 5: Poor)

PERSONALITY STATEMENTS (1: Never apparent, 2: Rarely apparent, 3: Sometimes apparent, 4: Often apparent, 5: Not Known)

Integrity (keeps his/her word) Dependable (reliable and trustworthy) Leader (sets a positive example for others) Judgement (able to make reasonable decisions) Energy / Enthusiasm (dedicated and positive) Orderly (organized) Well-spoken (ability to speak in front of others) Flexible (can adapt to new/different situations) Initiative (voluntary self-starter) Cooperative (willing to help others) Honest (upright, truthful) Sense of Humor (can laugh at him/herself) Thorough (completes all aspects of the job) Tactful (delicate skill in saying/doing the right thing) Teachable Spirit (seeks feedback in order to improve) Courteous (respectful of others) Patient (not easily frustrated/discouraged) Alert (quickly grasps directions) Personal Appearance (clothing and grooming habits) Innovative (imaginative and creative)

Laziness Procrastination Critical of others Impractical Domineering Rebellious Irritable Discouraged Anxiety Moodiness Depression Argumentative Discusses problems with everyone Excessive alcohol use Illegal drug use Self-centered

CHARACTER QUESTIONS

Would you feel comfortable having your own child(ren) live in a cabin with the Applicant? Please explain.


What strong qualities does this Applicant possess which makes him/her a positive influence on
children and camp staff?


What specific weaknesses have you noted pertaining to the Applicant?


Please make any additional comments that may be helpful to us in determining whether we should
hire this Applicant as a camp counselor.


By submitting this reference form, I guarantee the statements to be true to the best of my knowledge. I understand that Camp Champions Staff might contact me if they have any further questions.

Thank you very much for completing this reference form and giving us the opportunity so that we can further consider the Applicant for employment with us this summer!
Call us with any questions at (830) 598-2571.