Killoqua Staff Applicant Reference Form

We appreciate your assistance in completing this form and returning it as soon as possible. The value of the camp experience is largely dependent upon effective staff leadership; we seek to hire strong, positive leaders. Staff members should be comfortable working with both youth and adults, and have the desire and ability to include all participants. Successful staff also enjoy outdoor living and possess the abundant energy that a camp job demands.nnPlease give us your candid opinion about this applicant. References are kept confidential.

Name of Applicant*
How Long have you known applicant?*
In what capacity*
If you were an employer, would you re-employ this applicant?*
- Yes
- No
Assessment
Please indicate your assessment of the applicant in each of these areas:
Physical Health*
Personal relations with youth*
Personal relations with peers.*
Personal relations with older adults*
Sense of humor*
Responsibility*
Flexibility*
Judgement*
Emotional Stability*
Leadership*
Interest in working with children*
Cooperation*
Receptive to new ideas*
Initiative / Ability to motivate self*
Social poise*
Tidy personal appearance*
Accepts supervision and guidance*
Outdoor skills*
Creative skills*
Are you willing to have a child of yours under the leadership and influence of the applicant?*
- Yes
- No
To the best of your knowledge, has the applicant ever had trouble with drugs?*
- Yes
- No
To the best of your knowledge, has the applicant ever had trouble with alcohol?*
- Yes
- No
Any additional comments about the individual.
Your information
Your Name*
Position*
Email*
Telephone*
Address
City
State
Zip

Young people want to shape the world.

Camp Fire provides the opportunity to find their spark, lift their voice, and discover who they are.

In Camp Fire, it begins now.

Light the fire within

Killoqua Staff Applicant Reference Form

Killoqua Staff Applicant Reference Form

Assessment

Your information