Please complete the form below to provide a reference for the applicant.CompanyThis field is for validation purposes and should be left unchanged.Applicant Reference FormThe applicant has authorized Club SciKidz to collect any information orally or in writing about their qualifications and past performance. In the interest of providing the best environment for the children attending our programs, please provide your frank and honest opinion of the applicant. Your report will be held confidential and for Club SciKidz records only.Applicant's Name*Please provide the name of the applicant for whom you are completing the reference form. First Last Ability to Cope with Stressful Situations*Working at camp is physically and emotionally demanding and often requires coping without privacy. Please discuss the applicant's skill and/or ability in dealing with these and other stressful situations, as you have observed them.Experience working with Children*Have you seen the applicant work with children? If so, under what circumstances? Please describe what you have observed.RatingPlease review the following an drate how well the applicant demonstrates each quality by selecting the corresponding number with 1 indicating Poor and 5 indicating Excellent.Appropriate Dress/Grooming* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentAttendance/Punctuality* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentCommitment/loyal/ honest/discretion* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentCommunication skills written/oral* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentProfessional judgment/rational reasoning* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentCooperates with others/provides assistance* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentContent knowledge/innovative* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentNew ideas/flexible to change* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentBuild rapport with students and staff* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentUtilizes a variety of instructional strategies* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentClassroom management, fair, timely and consistent* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentCommunication with students, parents and staff* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentTeam player* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentEffectiveness at Duties/Assignments* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentFriendliness* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentRespect for Confidentiality* Unsatisfactory Below Expectations Satisfactory Exceeds Expectations No basis for judgmentHow likely would you be to hire/re-hire the applicant?* Very Somewhat Unsure Unlikely N/AWould you want the applicant to be your child's counselor?* Absolutely Probably Unsure Unlikely NoAdditional CommentsIf you have additional comments you feel are pertinent to the application for this position, please include them here.Relationship to the applicant*Work under my supervisionCo-workerStudent teacher under my supervisionOtherYour Name* First Last Signature*Title*Phone*Please include a phone number where we can reach you.Email* Δ
