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Title
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First Name
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Last Name
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Address
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Address 2
City
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State/Province
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Postal Code
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Email Address
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Phone
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Name of the Summer Staff Applicant you are providing the reference for?
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How Long have you known the applicant?
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How well do you know the applicant?
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Would you be pleased to have you children in the care of this individual?
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What is their Spiritual Life and Church Involvement: like?
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What Strengths would the applicant bring to this position?
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What Characteristics of the applicant do you feel need further work or development?
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Describe any concerns or limitations you feel the applicant may have?
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Any further comments?
Would you like to be contacted regarding this reference?
yes
no
Please rate this application in the following areas on a scale of 1 to 5, where 1 is needs a lot of improvement, 2 is needs improvement, 3 is average, 4 is good and 5 is great.
Spiritual Experience
1
2
3
4
5
unknown
Love for Others
1
2
3
4
5
unknown
Spiritual Maturity
1
2
3
4
5
unknown
Witness by Word/ Life
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2
3
4
5
unknown
Personal Bible Study/ Prayer
1
2
3
4
5
unknown
Emotional Stability
1
2
3
4
5
unknown
Self Control
1
2
3
4
5
unknown
Integrity
1
2
3
4
5
unknown
Work Ethic
1
2
3
4
5
unknown
Initiative
1
2
3
4
5
unknown
Leadership
1
2
3
4
5
unknown
Reliability
1
2
3
4
5
unknown
Response to Authority
1
2
3
4
5
unknown
Attitude toward others
1
2
3
4
5
unknown
Compassion and Empathy
1
2
3
4
5
unknown
Ability to Forgive
1
2
3
4
5
unknown
Conflict Resolution
1
2
3
4
5
unknown
Social Maturity
1
2
3
4
5
unknown
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