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Reference Questionnaire

Applicant Name:

has applied to work this summer as a counselor and has given your name as a reference. We would appreciate an honest appraisal of the applicantÕs qualifications and character. Please withhold nothing, favorable or unfavorable. Your opinion will be treated as confidential, and will be an important consideration in our decision. If between now and the summer you become aware of any situations that would not make the applicant a good choice for Skyline, we would appreciate a confidential call from you.

 
Your Name:
How long have you known the applicant?
Relationship to the applicant:
How well you know the applicant:
 
 

Please check any traits that characterize the applicant

What are the applicantÕs two greatest strengths?
What are the applicantÕs two greatest challenges?
Would you be willing to have your children under the applicantÕs supervision for a period of two weeks in a camp situation? Why or Why not?
How does the applicant react in situations of stress?
How does the applicant respond to criticism?
To what extent are you aware of the applicantÕs use of alcohol and/or drugs?
Are you aware of any accidents, injuries, or illnesses that might effect performance?
Are you aware of any questionable situations the applicant has been involved in with reference to relationships with peers or children? (i.e. abuse situations)
Have you seen the applicant in a leadership position with children? Is so, what?
Emotional stability of applicant:
Applicant spends time with children:
ApplicantÕs lifestyle exemplifies a Christian life:
If you were putting together a team, in what role would you want the applicant to serve?
 

Please evaluate the applicant on the following:

Reputation
(well thought of and respected at home and on campus)
Health and Vitality
(ability to endure a vigorous schedule)
Maturity
(self-disciplined, sound judgment, emotionally stable)
Oral Expression
(proper use of English language and ability to present thoughts clearly)
Alertness
(mental agility)
Teamwork
(ability to function in a team environment)
Work Ethic
(attitude towards work, willingness to accept responsibility)
Flexibility
(ability to adapt to new and different situations)
Spiritual Maturity
(knowledgeable and solid in religious convictions)
What level of communication have you had with the applicant in the past year?
Do you know of any lifestyle, conduct, or activity in which the applicant is involved that would be unfavorable to SkylineÕs ministry or the program's credibility?
Overall, how would you rate the applicant?
Additional Comments
Signed (your name):
Date
Phone
Email Address: