Applicant's Name:
Date: (mm/dd/yy)

We are considering this applicant for a position on our camp staff. All information that you provide will be held in strict confidence and will be considered confidential between the reference and the camp.

Sincerely,

Billy Breitner
Owner/Director

Applicant's Energy Level
Appearance, Speech, and Manner
Applicant's Maturity Level
Ability to work with close supervision
Ability to work without supervision
Sense of Responsibility
Dependability
Ability to work with others
Ability to relate to and care for children
Ability to work hard under stress
Ability to communicate with children
Ability to communicate with peers
Ability to communicate with authority figures
Ability to accept criticism
Ability to be a leader
   
What is your relation to the applicant?
How long have you known the applicant?
If the applicant worked for you, what was his/her position?
What was the reason for termination of employment?
Would you rehire the applicant? Yes     No
What age is the applicant best suited to work with?
Additional Comments:
Your Name:
Phone:
Email:
Address:
City:
State:
Zip:
Rollin Hills Day Camp Homepage.