Recommendation Request Form

To the best of your knowledge, has this applicant had any trouble with drugs, alcohol, and/or excessive traffic violations?

YesNo
To the best of your knowledge, has this applicant ever been convicted or accused of child abuse, neglect, or sex-related crimes?

YesNo

Please describe the applicant’s notable qualities, abilities, skills, interests, training, or experience which may be related to the position s/he is applying.
Please comment on any reservations you have or potential weaknesses you see in the applicant that may relate to the position applied for.
Inclusion Statement

Camp Fire Inland Northwest Council works to realize the dignity and worth of each individual and to eliminate human barriers based on all assumptions that prejudge individuals. Our programs are designs and implemented to welcome all regardless of age, color, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status and other characteristics that make our community vibrant and diverse.
How would you rate this individual on relationships with other people?

OUTSTANDING: Unusually effective, works well alone or in groups; can lead or follow as the occasion demands.GOOD: Works very well with others; highly respectful.AVERAGE: Usually effective; sometimes accepting, occasionally not.BELOW AVERAGE: There is reason to believe s/he will have difficulties working with other people.POOR: Cannot work effectively with others.

Please indicate your overall recommendation for this applicant to work with young children as a staff or adult volunteer for Camp Fire Inland Northwest:

I recommend this applicant without reservation as an excellent prospect.I recommend this applicant as a good prospect.I have reservations, but feel there is a reasonable chance this applicant will succeed.I have substantial doubts about this applicant.I feel this applicant is unsuited for the position in which s/he is applying.
Is there anything else you would like to tell us about this applicant?
Recommendation Writer's Name*

First NameLast Name
E-mail
Phone Number*

Area CodePhone Number
Address

Street Address (Include Suite or Apt. number)

Street Address Line 2

CityState

Zip Code
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Signature*

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