TSCC Reference Form

RECOMMENDATIONS FOR TEAM MEMBERS - TOTARA SPRINGS CHRISTIAN CENTRE

Please take a moment to complete the information below. An email PDF will be sent to TSCC Office when you click "submit" at the bottom of this form.
If you have any questions or concerns, please call our office at 07-888-4700 or email us at accounts@totarasprings.org.nz
Your Name (Person filling out the form)

First NameLast Name
Which category of reference are you for the applicant?*

FriendPastoral / Mentor / OtherEmployer / Teacher
Their Name (Person who is applying to work at TSCC)*

First NameLast Name
The early return of this form will be appreciated as it will expedite the processing of this candidate's application. Any information, which you give us, will be regarded as strictly confidential. This form will be sent directly to Totara Springs.
How long have you known the applicant?*
In what capacity?*
Is the applicant a Christian?*

YesNoNot sure
Please list the strengths and areas of improvement of the applicant.
Areas of Strength*
Areas of Improvement*

Please check what best describes the applicant.*

	Generally	Sometimes	Not Often	Not Observed
Able to follow instructions
Loyal
Gritty
Outgoing and friendly
Organized
An able leader of others
Consistent in Christian testimony
Disciplined in personal habits
Enthusiastic
Able to adjust to different situations
Able to cope with other's problems
Easily offended
Inclined to criticize others
Moody
Talkative
Able to work in a team situation

Comments about any of the above attributes

Please grade the applicant 1, 2, 3, or 4 on the following characteristics and traits: Superior; Above average; Average; Weak in that area. Please evaluate the applicant in relationship to his/her own age group.*

	1 Superior	2 Above Average	3 Average	4 Weak	Not Observed
Personal appearance
Courtesy
Honesty and personal integrity
Initial impression
Physical condition
Willingness
Dependability
Punctuality
Judgment
Ability to make friends
Sense of humor
Proper attitude toward authority
Initiative
Attitude toward hard work

Comments about any of the above characteristics

Would you describe the applicant as Introverted/Extroverted*

	1	2	3	4	5

1 is Introvert, 5 is Extrovert

To your knowledge has the applicant ever been charged with or convicted of any criminal offense?

YesNo
Additional Comments:
Are you recommending the applicant because of what they can contribute to our camping program, or because of what we can do for him/her, or both?*

What they can contributeWhat we can do for him/herBoth
Information about you!
Your Name*

First NameLast Name
Your Position
Your Organization
Current E-mail Address:*
Best Phone Number:*

Area CodePhone Number
How strongly would you recommend {theirName3} for a role with Totara Springs*

I strongly recommendI recommendI recommend with some reservationI do not recommend
Should be Empty:

RECOMMENDATIONS FOR TEAM MEMBERS - TOTARA SPRINGS CHRISTIAN CENTRE

Information about you!