Staff Development Reference Form

Candidate Information

Candidate First Name *

Candidate Last Name *

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Reference Information

First Name *

Last Name *

Phone #

Email Address *

Did the candidate ask to use your name as a reference? *

Select... Yes No

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Personality Traits

On a scale of 1-5 (with 1 being the lowest, 5 highest) how well does the candidate display the following personality traits?

Maturity *

1 2 3 4 5

Enthusiasm *

1 2 3 4 5

Leadership *

1 2 3 4 5

Teamwork *

1 2 3 4 5

Dependability *

1 2 3 4 5

Positive Attitude *

1 2 3 4 5

Time Management *

1 2 3 4 5

Self-Confidence *

1 2 3 4 5

Trustworthiness *

1 2 3 4 5

Respect for Authority *

1 2 3 4 5

How do you feel the candidate would perform when working with children ages 7 - 16? *

Do you think this candidate would thrive in an environment where he/she is away from home, in our camp environment, for multiple weeks? *

Do you recommend that we accept the candidate? Please explain. *

Additional comments:

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Thank you for taking the time to fill out this form. If we have any comments or concerns, we may contact you again.

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