Thank you for your willingness to take the time to fill out this form. It should take no more than 10 min of your time. Please fill out as much contact information as you are able, in case we need to contact you for clarification or more information. This form is hosted off-site in order to keep your information secure. This reference will also be kept confidential. ~Camp JIM Staff~
It is our desire to hire staff that is trustworthy, capable, caring, and motivated to provide leadership, compassion, discipline and a positive role model to our campers (ages 6-18). We are looking for staff who have demonstrated personal integrity, positive character attributes and spiritual growth on a consistent basis in their day to day lives. Please give your candid, honest, balanced evaluation of the applicant based upon your personal observation of her/him in all settings, emphasizing information that pertains to the applicant's character and conduct during the past two years. Your time and effort is greatly appreciated!
Name of Applicant
*
Position (if known) applicant is applying for
Your Name
Your Title
Organization
Address
Phone
Alternate/Cell Phone
How long have you known the applicant and in what capacity?
How frequently have you had personal contact with the applicant over the last two years and what is the average duration and the nature of those contacts?
If the applicant is related to you by blood, marriage, or adoption, please specify what the nature of the relationship is.
Does the applicant demonstrate a lifestyle committed to spiritual growth and moral integrity?
Always
Usually
At Times
Seldom
Comments
If you had a child of camper age, would you be comfortable leaving your child in the care of the applicant?
Yes
Maybe
No
Comments
Does the applicant have difficulty or cause problems when being subject to or working under authority?
Never/Extremely Rare
Occasionally
Often/Usually
Comments
What are the applicants greatest spiritual, emotional, behavioral and character strengths?
Please also list any weaknesses in these areas and how she/he has attempted to address any weaknesses.
Please grade the applicant on the following to the best of your knowledge. Consider "1" as low or poor and "10" as high. Feel free to answer NA for no or insufficient knowledge.
Temper Control
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1
2
3
4
5
6
7
8
9
10
Willingness to Serve
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1
2
3
4
5
6
7
8
9
10
Initiative
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1
2
3
4
5
6
7
8
9
10
Emotional Balance
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1
2
3
4
5
6
7
8
9
10
Leadership Ability
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1
2
3
4
5
6
7
8
9
10
Dependable
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1
2
3
4
5
6
7
8
9
10
In recommending this applicant for the position applied, I would:
Highly Recommend
Recommend
Recommend with Reservation
Not Recommend
Any additional comments or concerns:
Security Code
*
