Counselor Reference - General Reference's Name * Reference's Name First Name First Name Last Name Last Name Title Counselor's Name * Counselor's Name First Name First Name Last Name Last Name Camp Session(s) Counseling (i.e. Younger Middler, High School 1…) * Address * Email * Phone Number * How long have you known this person and in what capacity? * Does this person relate well with adults? * Select one optionYesNo Is this person active in their local church? * Select one optionYesNo If yes, in what capacity? Does this person seem mature in handling discipline? * Select one optionYesNo Does this person seem to respond well to authority? * Select one optionYesNo If you had a child under this person’s care in their cabin, would you feel good about it? * Select one optionYesNo Why or why not? * How does this person relate with children and youth? * How long has this person been at their place of employment? * Are you aware of any accusations of misconduct against this person? * Select one optionYesNo If so, please explain: Would you recommend this person as a camp counselor without reservations? * Select one optionYesNo If not, what are your reservations? * By checking this box, I certify that this form is filled out as accurately and truthfully as possible. Submit If you are human, leave this field blank.
