School Age Children’s Programs Reference Form

Name of Applicant: ______Name of Reference: ______

Position Applied For: ______Address/Phone: ______Company: ______Position: ______

To those asked to submit references: We are interested in your candid assessment of the applicant's abilities. References are integral to our hiring process and we will defer any action on this application until hearing from you. Your thoughts are appreciated.

For how long and in what capacity have you known the applicant? ______

Please circle the appropriate response for each category, which, in your judgment, most accurately describes the applicant.

Maturity and
Judgment / Below Expectations / Meets Expectations / Above Expectations / Have Not
Observed / Comments
Dependent, unable to reach decisions or cope with frustrations. / Normal good judgement, usually copes with frustrations, clear thinker. / Exceptional judgement copes well with frustrations.
Dependability
And
Reliability / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Doubtful reliability, considerable checking on work required. / Consistently reliable, makes only minor mistakes. / Exceptional reliability, very accurate work.
Emotional
Stability / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Easily disturbed, insecure. / Usually stable and poised, is well adjusted, self-confident. / Very stable, well balanced, poised.
Initiative,
Originality / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Needs prodding and is dependent on others, wastes time. / Does assigned work on own accord, needs little help. / A self-starter, independent and imaginative.
Personal
Presentation / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Careless, discourteous. / Well mannered, courteous. / Impressive, cordial to all, very courteous.
Team Member / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Does not work well with others, resents criticisms. / Works well with others accepts corrections, tries to improve. / Always willing to be a team member, invites criticisms and improvements.
Communication
Skills / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Deficient in ability to express themselves. / Able to express themselves. / Expresses themselves clearly and effectively.
Character and
Integrity / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Compromises ethics for personal gain, questionable honesty. / No serious flaw in integrity or ethics, dependable. / Absolutely trustworthy, observes high quality ethics.
Leadership
Capabilities / Below Expectations / Meets Expectations / Above Expectations / Have not Observed / Comments
Unable to lead, ineffectual. / Occasionally a leader, confident. / Frequently a leader, often outstanding, inspiring.
  1. What were the applicant’s key responsibilities at your company/program? ______
  2. Have you seen this person interact with children? Please describe: ______
  3. This person is applying for a job as a camp staff member. Is there any reason that he or she should not be hired for this position? Why or why not? ______
  4. Please add any additional comments you feel we should know about the applicant: ______

Signature: ______Date: ______

Please return this completed reference to:

Camp Sisol 1200 Edgewood Avenue Rochester, NY 14618

Or Fax to: 585-625-0820

Or E-mail to:

THANK YOU!