4-H Camp Bristol Hills Staff Reference Form
Cornell Cooperative Extension of Ontario County is currently recruiting to fill staff vacancies at 4-H Camp Bristol Hills. You have been selected to provide a reference for an applicant. At 4-H Camp Bristol Hills, we pride ourselves in selecting qualified and dedicated individuals to work with children ages 5-15 years. Your assistance in this process is greatly appreciated. (Note: References will be accepted from adults who can speak credibly and without bias, to the candidates work ethic. New staff are required to submit THREE references. One of those references MAY include a current camp staff member. References from friends, or parents of friends will not generally be accepted, unless they have also served as a current or former employer of the candidate.)
Name of Applicant
What position is the candidate applying for?
How long have you known the applicant?
In what capacity have you known the applicant?
Please Select
Employer
Professional Peer
Other
If "Other", please explain:
If you were a former employer, would you consider rehiring the applicant?
Please Select
Yes
No
Maybe
If "No" or "Maybe", please explain:
Please rate the applicant in the following areas:
Rows
Poor
Fair
Good
Very Good
Excellent
N/A
Ability to work with children ages 5-7
Ability to work with children ages 8-10
Ability to work with children ages 11-13
Ability to work with children ages 14-16
Ability to take a leadership role
Shows initiative and creativity
Is responsible and reliable
Shows enthusiasm
Possesses a sense of humor
Ability to accept constructive criticism
Uses mature judgement in decision making
Is self-confident
Exhibits sensitivity and patience with children
Capable of handling emergency situations
Is prompt and conscientious
Is honest and dependable
Acceptable professional appearance
Ability to be an appropriate role model
Human relations skills
Communication skills
Problem solving skills
Capable of living in an outdoor environment
Please provide any comments relating to the skills noted above:
What skills or special abilities do you feel this individual has that qualifies the applicant for a camp position?
Would you trust this individual to care for your own children?
Please Select
Yes
No
Not applicable
If "no", please explain:
Please select and explain your endorsement of this applicant:
Please Select
Can not recommend for a camp position
Recommend with some reservation
Recommend for a camp position
Highly recommend for a camp position
Please explain your choice:
Any additional comments regarding this applicant?
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Personal Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Signature
Please verify that you are human
*
Thank You!
Immediate response is critical to the setting up of an interview for this applicant. Please submit within one week.
Submit
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