Camp Gifford

APPLICANT'S First Name *

Applicant's Middle Initial (if known)

APPLICANT'S Last Name *

How long have you known the applicant? *

If Other, Please Describe:

How would you rate the applicant's level of resourcefulness and initiative? *

Above Satisfactory

Satisfactory

Below Satisfactory

How would you rate the applicant's ability to use good judgment in normal conditions? *

Above Satisfactory

Satisfactory

Below Satisfactory

How would you rate the applicant's ability to use good judgment in stressful conditions? *

Above Satisfactory

Satisfactory

Below Satisfactory

Please comment on the applicant's strengths. *

Please comment on the applicant's weaknesses. *

How would you rate the applicant's ability to work with and relate to other adults? *

Above Satisfactory

Satisfactory

Below Satisfactory

How would you rate the applicant's ability to work with children? *

Above Satisfactory

Satisfactory

Below Satisfactory

Please give an example of how the applicant relates to children. *

With what types of children have you observed the applicant working well? *

With what types of children have you observed the applicant not working well? *

Have you ever known the applicant to use harsh or abusive discipline with a child? *

Yes

Would you be comfortable placing one of your own children in the care of the applicant? *

Yes

How would you rate the applicant's ability to maintain appropriate boundaries with children? *

Above Satisfactory

Satisfactory

Below Satisfactory

Are you aware of any reason why we should not allow this applicant to work with children? *

What can you tell us about the applicant's hobbies and recreational activities? *

We are looking for someone who can stay calm and control frustration even under very frustrating conditions with children. How would you rate the applicant's ability to be patient and calm? *

Above Satisfactory

Satisfactory

Below Satisfactory

Please comment on the applicant's character and personality. *

How would you rate the applicant's spiritual commitment and influence? *

Above Satisfactory

Satisfactory

Below Satisfactory

Unknown

How would you rate the applicant's attitude toward church? *

Above Satisfactory

Satisfactory

Below Satisfactory

Unknown

If you are recommending this applicant, you are doing so... *

Because of what they can contribute to Camp Gifford

Because of what Camp Gifford can do for them

Both of the above

I an NOT recommending this applicant.

Is there anything else you would like to let us know about the applicant?

Please fill in the following information about yourself.

First and Last name of Referrer (person filling out this form) *

Email *

Phone *

We randomly select referrals for verification. What is the best time and phone number to reach you at if we need to verify this information (the call will be brief). *

Please type the words you see below into the box to prove you're a human :-)

Untitled

Youth and teen summer camps and retreat facilities

Reference Form

Please fill in the following information about yourself.

Please type the words you see below into the box to prove you're a human :-)

Thank you for your honest, confidential, information. Providing safety for our children is our main priority. God bless!