Name (Required)

Email Address (Required)

What is the name of the individual you are completing this reference for? (Required)

How long have you known this applicant? (Required)

What is your relationship to the applicant? (Required)

How would you rate the applicant's ability to work with and relate to children? (Required)

Have you seen the applicant working with children or students first hand? Can you give an example of how the applicant relates to children? (Required)

How would you rate the applicant's ability to be patient and stay calm? (Required)

Have you ever known the applicant to use harsh or abusive discipline with a child? Do you know of any reason the applicant would pose a danger to any child? (Required)

Would you be comfortable placing one of your own children in the care of the applicant? Why or why not? (Required)

What are the applicant's hobbies and recreational activities? (Required)

How would you rate the applicant's ability to relate to adults? (Required)

Can you give me an example of how the applicant relates to adults? (Required)

How would you rate the applicant's ability to be genuinely supportive and understanding to a person in need? (Required)

If you can think of a time when the applicant was able to show genuine concern for a person who needed comfort, please tell about that time. (Required)

Do you have any additional comments, concerns, or questions? (Required)

Do we have permission to share any of the above information with the applicant if needed? (Required)

I have answered the questions accurately to my knowledge and shared any applicable concerns that would help in deciding whether this individual should be serving at camp. (Required)