Counselor Recommendation Form

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Piedmont Bible Camp

Counselor Recommendation Form
Name of Counselor Applicant
First name *
Last name *
General Impression
Rate the following qualities of the applicant.

	Excellent	Above Average	Average	Below Average	Poor	No Information
Spiritual influence
Spiritual involvement
Support of SDA Beliefs
Judgment
Cooperation & Initiative
Dependability
Leadership Potential
Resourcefulness
Intellect
Personality
Personal Relationships
Adaptability
Appearance
Emotional Stability

Specific Qualities
Check any attributes as they relate to the applicant.
Spiritual Influence

Positive Passive Negative
Spiritual involvement

Dedicated Growing Searching
Support of SDA Beliefs

Active support Passive support Resistant
Judgment

Mature Adequate Inconsistent Poor
Cooperation & Initiative

Helpful Willingly obeys guidelines Erratic
Dependability

Reliable Erratic Poor Easily distracted
Leadership Potential

Natural Latent Follower
Resourcefulness

Self-starter Persevering Creative Able to improvise Needs supervision Easily discouraged
Intellect

Quick Average Slow to grasp concepts
Personality

Extroverted Well-balanced Reserved Accepts criticism Self-confident Mature Unselfish Self-centered Easily offended
Personal Relationships

Tasteful Inappropriate Excessive physical contact
Adaptability

Flexible Open-minded Tactful Outspoken Prejudiced Rigid
Appearance

Well-groomed Relatively neat Careless Slovenly
Emotional Stability

Self-controlled Stable Easily disturbed Unstable
Please provide any additional comments about the above ratings here:
How long have you known the applicant?
In what capacity?
In the last year, are you aware if the applicant has been involved with the use of illegal drugs, alcohol, or inappropriate relationships?

Yes No
If yes, please explain:
Would you feel comfortable with this applicant caring for your child in a camp setting?

Yes No Not sure
Please write any further information which would be helpful to the directors in appraising the applicant:
Name

First Name Last Name
Phone Number

Area Code Phone Number
Date

Month Day Year
Date
Should be Empty:

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Piedmont Bible Camp