Summer Staff Reference Form FieldsetName of Applicant *Please enter the name of the person who asked you to fill out this formInstructions The person that has asked you to fill out this form has applied to be a part of the summer staff ministry at Kellogg Springs Camp. This camp is owned and operated by the Oregon Pacific District Church of the Nazarene. If chosen, the applicant will be doing various tasks, including, leadership in Programming, Housekeeping and working with other Summer Staff. Our main concerns for the applicant are his/her personal spiritual life and desire to share their faith as well as their maturity in making good decisions and working in a team environment. I encourage you to give your evaluation of the applicant as you have seen him/her live and perform on a daily basis. It is our desire to hire a staff person who is trustworthy, caring and loving toward children, teens and adults. It is imperative that all our summer staff are positive role models. Thank you. Your feedback is greatly appreciated! -Missy Humber, Executive DirectorReferent InformationYour Name *How long have you known the applicant? *How would you categorize your relationship to the applicant? *Close FriendAcquaintanceMentorProfessionalPerception of The ApplicantDo you have any reservations about this applicant's moral integrity? *How is the applicant's relationship with God visible? *What is one challenge you would give to the applicant for his/her own personal growth? *How would you describe the applicant's attitude toward authority? *How would you describe the applicant's reliability? *AttributesInstructions Please enter the appropriate number for the following attributes. (1= Poor, 5= Average, 10=Excellent).FOLLOWS INSTRUCTIONS *12345678910OUTGOING *12345678910FULFILLS OBLIGATIONS *12345678910SENSE OF HUMOR *12345678910ENERGETIC *12345678910TRUSTWORTHY *12345678910GETS ALONG WITH OTHERS *12345678910TACT *discretion with words12345678910LEADERSHIP ABILITY *12345678910FRIENDLINESS *12345678910Comfortability of ApplicantIf you had a child of camp age, how would you feel about having him/her spend five days at camp with the applicant? As a spiritual teacher? *PositiveComfortableAverageConcernedDuplicating the applicant's mannerisms? *PositiveComfortableSo-SoConcernedOur summer staff aren't cabin counselors but if they were, how would you feel about them being one for your child? *PositiveComfortableAverageConcernedFurther Discuss (optional)I prefer to discuss this applicant further... Please call me at: VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
