Online Reference FormOnline Staff Reference

Name of Staff Applicant

The above named person is applying for summer employment at Point O'Pines Camp for Girls. Point O'Pines Camp for Girls is a residential camp. Most of our employees live with our campers and are responsible for their care 24 hours a day. With this in mind, you have been chosen by the applicant to submit your comments on the applicant's qualifications for this type of employment. The questions posed on this form are important for the Directors, who appreciate you answering them candidly. Please do not feel limited by the scope of the questions. Cover any topic or add any statements that you feel relevant in evaluating the applicant. The information you provide will remain confidential. Thank you for your assistance.

How long have you known the applicant?

In what capacity?

Would you hire/rehire this person?
 Yes No Not Applicable

If no, for what reason?

Please rate the applicant on the following characteristics:

How would you rate the applicant's emotional stability and patience to teach, play, and live with children on a 24-hour a day basis?

Would you feel comfortable having the applicant be responsible for your child?

Assess the applicant's ability to work in a group setting - is she/he a team player?

How would you rate the applicant as a role model for children?

What words or phrases immediately come to mind when describing the applicant?

What weaknesses or limitations have you observed in the applicant?

To the best of your knowledge:

Has the applicant every had any criminal convictions for child abuse or sexual abuse offenses?
 No Yes

Has the applicant ever had any criminal convictions for a felony or misdemeanor?
 No Yes

My overall recommendation:

 Enthusiastically Recommend Recommend Recommend with Reservations Do not Recommend

If Recommend with Reservations, please explain:

We will be contacting you for a few follow up questions. Please fully complete the following section.

Your Full Name

Your Email Address

Occupation

Address

Daytime Phone Number

Evening Phone Number

Best time to reach you