Arlene Streisand's
Summer Camp Services
P.O. Box 196
Jericho, NY 11753
1-800-443-6428 • • • 516-433-8033
Fax: 516-933-7949
PRINT
THIS Recommendation Form FIRST!
Two
references are required
When completed
fax to: 516-933-7949
Reference for:______________________________
Who has applied to us for the position of:_________________________
Since we wish to engage people with proven ability and emotional stability, we would greatly appreciate your frank opinion. If you do not know the applicant in a camp setting, answer the questions below from your own frame of reference. We wish to thank you for your kind cooperation and assure you that your information will be held in the strictest confidence.
Superior |
Average |
Poor |
|
| Ability to teach above listed skill | ___Hi ___Low | ___Hi ___Low | ___H i___low |
| Warmth and liking to children | ___Hi ___Low | ___Hi ___Low | ___Hi___Low |
| Understanding of needs of children | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Ability to be fair - not partial | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Imagination and enthusiasm | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Ability to get along with people | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Health, energy and endurance | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Ability to accept responsibility | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Adaptibility to structure | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Willingness to learn | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Reaction of people to applicant | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Personal appearance | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
| Maturity compared to peers | ___Hi ___Low | ___Hi ___Low | ___Hi ___Low |
To the best of your knowledge has the applicant ever been investigated for allegations of child abuse?_________________________________________________________________
To the best of your knowledge has the applicant ever been convicted of a felony or misdemeanor which resulted in imprisonment?________________________________________________
How do you know applicant?_________________________________________________
________________________________________________________________________
Your Name (Please Print)____________________________________________________
Position:_______________________Organization:________________________________
Signature:____________________________Phone: ______________________________
Additional comments on back would be helpful. Thank you.
This reference form should be completed by a former employer, coach, teacher or other professional, NOT be a roommate, friend, neighbor, etc.
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