2026 SMILE Camp Counselor Reference Form

The student who sent this form to you is applying to be a SMILE Camp Counselor. SMILE Camp is a week long day camp for elementary aged campers who are living with physical impairments, intellectual disabilities, autism, hearing, and/or visual impairments.

Who attends Smile Camp: Elementary aged campers with Special Needs across Northeast Florida enjoy camp adventures during this day camp full of fun.

Overview of Camp Counselor Duties: Cadette, Senior and Ambassador Girl Scouts, rising 9th - 12th graders, may apply to become counselors for this camp. Counselors are paired with a special camper for the event. Counselors receive training to provide encouragement, physical assistance and instruction for giving one-on-one attention to the campers. In addition to the bond they often form with campers, the leadership and training benefits for the older Girl Scout participants are invaluable. This camp, planned and staffed by Cadette, Senior and Ambassador Girl Scouts has been creating SMILES on the faces of campers and counselors alike for over 50 years.

SMILE Camp Counselor Applicant Name*

First NameLast Name

Your Name*

First NameLast Name

How long have you known the applicant?*

What is your relationship to the applicant? (A reference should be a non-related Adult)*

Check on rating in each category to assess the following qualities of the applicant*

Rows	Don't know	Below Average	Average	Above Average	Exceptional
Accepts differences in people
Has poise and ease in meeting people
Is able to relate well to adults
Is able to relate well to peers
Is able to share ideas/feelings
Is able to work well in a group
Is adaptable and flexible
Is dependable and responsible
Is physically fit
Shows humor and spontaneity

Describe the applicant's strength and/or skills as they relate to working with children. Please give specific examples.*

What is your assessment of this applicant's potential for success as a counselor for SMILE Camp? Please be as honest and objective as possible in your remarks.*

*By singing my name below I agree that the information contained in this form is accurate to the best of my knowledge.

Today's Date*

MonthDayYear

Email*