Hello!

You have been requested to complete a reference for a potential counselor for a youth summer camp. This questionnaire will help us assess the candidate’s personality and skills, as they would relate to such a position. Your familiarity with the candidate will provide us with some of the important information necessary to successfully arrive at our hiring decision.

Personal and employment references are among the most important criteria upon which we base our decisions.

Southwoods is a co-ed camp with boys and girls ranging in age from 7-16. Counselors working in the camp environment are faced with a very demanding and often difficult job. They live, work, eat, sleep and play with the kids on a day to day basis, over eight weeks. During that time they will have 6 - 7 days off and one hour off per day. Kids at camp are active, and the counselor will be asked to participate in and instruct (or assist in instructing), the many different activities offered as part of the program. We offer skill development in all areas of land and water sports, backpacking and outdoor living and a superb experience in both performance and fine arts.

Staff members who join our staff do so with the understanding that ours is a caring and sharing environment with the focus on creating the best possible experience for our campers. Our staff members are expected to give 100% effort towards the needs of the campers and the camp program.

We will be speaking with the applicant and assessing his/her various skills and background, however any information you offer creates a better overall view of the person. The information you provide us with is strictly confidential and will not be shared with the applicant. It us used only as a tool to assist us in our hiring process.

The submit button at the bottom of this page will send this information to us via the internet. If you encounter any problems, please email us at info@southwoods.com. Thank you for your honesty and assistance.

Sincerely,

Name of Applicant

Your Name

Address

Home phone

Work phone

Date Completed

What is your connection with the applicant?

How long have you known him/her?

Based on your knowledge of the individual, how well does he/she relate to children?

In your opinion what areas might this individual be most successful in? (activities, special skills, etc.)

How would you feel about this individual working as a counselor for a child of your own? Please explain.

To your knowledge, has the applicant ever exhibited abusive or sexually improper tendencies toward others?
Yes No

To your knowledge, has the applicant ever been convicted of a felony or a misdemeanor?
(Including but not limited to alcohol related offenses)
Yes No

Please indicate the appropriate rating for the following areas.

MATURITY	Superior	Above Average	Average	Below Average	Poor
CHARACTER	Superior	Above Average	Average	Below Average	Poor
DEPENDABILITY	Superior	Above Average	Average	Below Average	Poor
ENERGY	Superior	Above Average	Average	Below Average	Poor
LEADERSHIP	Superior	Above Average	Average	Below Average	Poor
MOTIVATION	Superior	Above Average	Average	Below Average	Poor
JUDGMENT	Superior	Above Average	Average	Below Average	Poor
COMMUNICATION SKILLS	Superior	Above Average	Average	Below Average	Poor
ENTHUSIASM	Superior	Above Average	Average	Below Average	Poor
PROFESSIONAL APPEARANCE	Superior	Above Average	Average	Below Average	Poor
WORK ETHIC	Superior	Above Average	Average	Below Average	Poor
SAFETY	Superior	Above Average	Average	Below Average	Poor
AWARENESS	Superior	Above Average	Average	Below Average	Poor

Please add any additional comments that might lend insight into the applicant’s ability to work in a camp environment with children.

Thank you again for your assistance and time.