Pleasant Bay Camp :: Reference Form for Staff/LIT Program

Please answer all the questions to the best of your ability. If you are unsure of an answer you may leave it blank. If you require clarification or need assistance you may email us at acabrals@yahoo.com. Thank you for taking the time to complete this form.

Serving on staff at Pleasant Bay Camp is an intense experience that will develop skills and challenge participants to lead, work, share, and sacrifice. If you have questions or would like more information regarding Pleasant Bay Camp please do not hesitate to contact us.

*	First Name:
*	Last Name:
*	Address:
*	City:
*	State/Province:
*	Zip/Postal Code:
*	Email Address:
*	Phone:
*	Name of Applicant
*	Your Position (teacher, pastor, employer, etc)
*	Relationship to the Applicant
*	How long have you known the applicant?
*	How well do you know the applicant?	very well well casually not very well
*	Would you hire the applicant? Why/why not?
*	How would you describe the applicant's personality? (shy/outgoing/observant/energetic/popular/disciplined)
*	How would you describe the applicant's relationship with Jesus?
	Please describe the applicant's attitude towards people in positions of authority.
	Please describe the applicant's attitude towards people of the opposite gender.
	Please describe the applicant's work habits.
	Please describe the applicant's desire for personal growth.
	Please use the following section to evaluate the characteristics of the applicant....................................................................................... Ability to Get Along with Others	Poor Average Above Average Excellent
	Potential to Lead	Poor Average Above Average Excellent
	Observed Leadership	Poor Average Above Average Excellent
	Concern for Others	Poor Average Above Average Excellent
	Ability to Relate to Children	Poor Average Above Average Excellent
	Dependability	Poor Average Above Average Excellent
	Emotional Stability	Poor Average Above Average Excellent
	Enthusiasm	Poor Average Above Average Excellent
	Initiative	Poor Average Above Average Excellent
	Integrity	Poor Average Above Average Excellent
	Work Ethic	Poor Average Above Average Excellent
	Health and Fitness	Poor Average Above Average Excellent
	Ability to Accept Correction	Poor Average Above Average Excellent
	Willingness to Follow Instructions	Poor Average Above Average Excellent
	What abilities, aptitudes or special characteristics does this applicant bring to serve at Pleasant Bay Camp?
	What difficulties might you anticipate as this individual works for long hours in close quarters?
	How can Pleasant Bay Camp best minister to the needs of this individual?
	Is there any other information that could assist us in the acceptance, placement and mentoring of this individual?