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Moorelands 2008 Summer Camp
Camp Staff Reference Form

 

Name of the applicant:
Your name
Your relationship to the applicant
employer, supervisor, teacher, peer
How long have you known
the applicant
We may telephone you if we have further questions. Please include your telephone number
Your E-Mail address
You will be contacted
to verify this reference)

 
Moorelands Camp works with Toronto youth affected by poverty to provide them with positive and fun experiences to help strengthen their confidence, competence and character. Your honest evaluation of the applicant's character and capabilities will be greatly appreciated. Please rate the applicant according to the statements on the left on a scale of STRONGLY AGREE to STRONGLY DISAGREE. Please give an explanation where possible.

The Applicant Strongly     Strongly
Agree «--» Disagree		 Comments
Displays emotional
maturity & stability
Accepts guidance, supervision
and feed back
Acts responsibly,
makes sound decisions
Displays a good
sense of humour
Adjusts well to new situations
Is able to lead or follow
as the occasion demands
Is willing to accept work assignments
and carry them out cheerfully
Demonstrates mature conduct
in peer relationships

 
Is he/she a smoker?
Yes No Not Sure

 

Please describe what you have observed when this applicant has worked with children/teens in a leadership role.
N/A
Comments
Would you be confident having this person as your child's cabin leader or activity instructor?
Yes No
Comments
Are there any characteristics which might reduce the effectiveness of the applicant
in the camp program or community?
Yes No
Comments
Does the applicant respect organizational boundaries and policies?
Yes No
Comments
Does the applicant get along well with peers and those in leadership?
Yes No
Comments
Additional comments:

Thank-you for your time and effort in contributing to the quality of our camp. If you have any questions or comments please call our Toronto office at 416-466-9987 x 306.

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