CLT Reference Questionnaire

Camper in Leadership Training

Reference Questionnaire
The person who sent you this link has applied for the InspireWorks Enrichment Camper Leadership Training (CLT) program and listed you as a reference. To be included in their application, please fill out the questionnaire below by May 8th.

CLTs work closely with campers, gaining hands-on experience while assisting staff in various areas of the camp. We’re looking for individuals who can be positive role models for young children.

Thank you for taking the time to complete this questionnaire and provide honest feedback about our future leaders.
Name of Applicant:*

First NameLast Name
Your Name:*

First NameLast Name
Your Email Address:*
example@example.com
Your Phone Number:*

Area CodePhone Number
How long have you known the applicant?:*

Less than 1 year1-2 years3-5 years6+ years
What is your relationship to the applicant?*

Family MemberCoachCounselorMentorReligious LeaderTeacherYouth Group or Extracurricular LeaderOther

How would you describe the applicant's maturity?:*

	1	2	3	4	5

1 is Very Immature, 5 is Very Mature

Please select 5 words below which you believe accurately describe the applicant:*

AdaptableAdventurousAmbitiousActiveArticulateCalmCaringCheerfulConscientiousCooperativeCreativeDecisiveDisciplinedEmpatheticEnergeticExtrovertedFirmFlexibleFocusedFriendlyFunnyGenerousGentleHardworkingHelpfulIndecisiveIntrovertedLogicalLoyalMeticulousNurturingObservantOptimisticOrganizedPatientPessimisticPlayfulProactiveProtectivePrecisePunctualReactiveRelaxedReliableResourcefulRespectfulResponsibleSensitiveSeriousSteadySystematicTransparentTrustingTrustworthyWarmOther
In what ways would this individual be a positive role model for children? Please explain:*
How would InspireWorks Enrichment benefit from having this individual as a CLT?*
Do you know of any concerns that could affect the applicant’s ability to succeed in the CLT role?*

NoYes
Please explain:
Should be Empty:

Camper in Leadership Training