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The following applicant has made application for a position as counselor at Camp Olympia this summer. We are looking for people who have enthusiasm, energy, initiative, and the ability to get along with children and adults. Because of the importance of the work and task of right selection, we would appreciate your candid opinion of the applicant.
 
Applicant's Name:

School:

Please choose the best answer for each characteristic below:
1) Tactful- delicate skill in saying or doing the right thing
Excellent Good Average Fair Poor
2) Judgement- able to make reasonable decisions
Excellent Good Average Fair Poor
3) Innovative- imaginative and creative
Excellent Good Average Fair Poor
4) Enthusiastic- dedicated and positive
Excellent Good Average Fair Poor
5) Honest- upright, truthful
Excellent Good Average Fair Poor
6) Initiative- voluntary starter
Excellent Good Average Fair Poor
7) Leader- positive example
Excellent Good Average Fair Poor
8) Dependable- reliable and trustworthy
Excellent Good Average Fair Poor
9) Courteous- respectful of others
Excellent Good Average Fair Poor
10) Thorough- completes all aspects of the job
Excellent Good Average Fair Poor
11) Cooperative- willing to help others
Excellent Good Average Fair Poor
12) Patient- is not easily frustrated or discouraged
Excellent Good Average Fair Poor
13) Alert- quickly grasps directions
Excellent Good Average Fair Poor
14) Orderly- organized
Excellent Good Average Fair Poor
15) Personal Appearance- clothing and grooming habits
Excellent Good Average Fair Poor
16) Laziness
Never Apparent Rarely Apparent Sometimes Often Not Known
17) Procrastination
Never Apparent Rarely Apparent Sometimes Often Not Known
18) Criticalness
Never Apparent Rarely Apparent Sometimes Often Not Known
19) Impracticality
Never Apparent Rarely Apparent Sometimes Often Not Known
20) Domineering Manner
Never Apparent Rarely Apparent Sometimes Often Not Known
21) Rebelliousness
Never Apparent Rarely Apparent Sometimes Often Not Known
22) Irritability
Never Apparent Rarely Apparent Sometimes Often Not Known
23) Discouragement
Never Apparent Rarely Apparent Sometimes Often Not Known
24) Anxiety
Never Apparent Rarely Apparent Sometimes Often Not Known
25) Moodiness
Never Apparent Rarely Apparent Sometimes Often Not Known
26) Depression
Never Apparent Rarely Apparent Sometimes Often Not Known
27) Argumentativeness
Never Apparent Rarely Apparent Sometimes Often Not Known

28) Would you be willing to have your child under the leadership and influence of the applicant for a whole summer?
Yes No
29) How long have you known the applicant?
In what capacity?

30) Please list five words that you feel best describe the applicant.
Use most descriptive word first.
a b c
d e
31) Your general estimate: (please choose one)
HIRE HIREABLE
32) Your Name:
33) Your Position:
34) Daytime Telephone Number:
35) Date:

We are counting on your opinion as one of the important factors in our decision. A statement from you in as explicit terms as you care to use will be held confidential. We shall be grateful for an early reply as the applicant cannot be considered for hire prior to this completed reference form being in our possession.
Please use the box below for any additional comments. We appreciate your time!
 

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