Counselor Reference Form

MIDSOUTH CAMP COUNSELOR

Reference Form

Please assist us in selecting our Midsouth Camp staff sponsored by the Midsouth Conference of the Evangelical Covenant Church. By completing this form, you will aid the application process and provide needed information to select the most qualified staff. All counselor references will remain confidential and are due by April 15. Please contact Dale "Munk" Lusk at dale.lusk@covchurch.org with any questions.

Counselor Applicant's Name*

First NameLast Name

How has the counselor applicant been involved in your church/organization during the past six months?*

How long have you known the applicant and what does your relationship look like?*

What type of example for Jesus Christ would you consider the counselor applicant to be?*

OutstandingExcellentGoodBelow average

If you indicated below average, what concerns do you have?

3. What are three of the counselor applicant's strengths for camp work?*

How well will the counselor applicant be able to follow the guidelines of the director and provide fair discipline to the campers?*

Very wellAverageBelow average

If you have concerns about the counselor applicant following guidelines or giving fair discipline, please comment:

What reasons would there be for you to hesitate this counselor applicant serving at camp?*

Your Name*

First NameLast Name

What church or organization do you lead*

Your title*

Your Phone Number*

Please enter a valid phone number in case we have questions about your reference.

Your signature*