Staff Reference Form 2026

Reference Form
This applicant is applying for a staff position at our overnight camp for children with cancer. Please take a moment to complete this form so we can thoroughly evaluate the applicant. Thank you for your time.
Name of Applicant

First NameLast Name
What is your relationship to the applicant?
How long have you known the applicant?
Would you feel comfortable if this person was caring for your child?

0/250

Please give your opinion of the applicant on the following:

Rows	Poor	Fair	Good	Great
Interaction with others
Capacity of leadership
Judgement in trying conditions
Emotional stability and maturity
Capacity for accepting differences in people

Please add any additional comments which will assist in providing a complete picture of the applicant's ability.
Your Name

First NameLast Name
Title
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: