Hampton Country Day Camp : HCDC Staff : Reference Form

The TLC Foundation
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- North Shore Day School
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request info about Hampton Country Day Camp

Applicant's Name: (Required)

The person named above has applied for a position as a counselor in our co-educational children's camp. Your critical appraisal and confidential evaluation of this person will be of great help in selecting our staff. It is most important for leaders of boys and girls to be of high ideals, possess integrity, get along well with others in the intimate life of camp, be a role model to children and demonstrate a willingness to do more than "his or her share." We would appreciate your providing confidential information about the applicant. On occasion, we find it necessary to hire on the basis of information supplied by references and statements made by the applicant. Therefore, we hope you will be quite frank, candid and objective so that we may avoid mistakes that could result in a serious inconvenience for us and perhaps termination for the employee. Thank you for your response and kind assistance.

Position Applying For:

Motivation (Desire to learn)
Enthusiasm
Loyalty
Emotional Maturity (self-control)
Social Acceptability (response from others)
Tolerance
Energy
Responsibility
Communication
Social Attitude (concern for others)
Humor
Understanding Children
Leadership
Ability to Accept Supervision & Guidance
Appearance
Summary

To the best of your knowledge has the applicant ever been investigated for allegations of child abuse? Yes No

To the best of your knowledge has the applicant ever been convicted of a felony? Yes No

Is there any reason you are aware of that this person should not work with children? Yes No

If yes, please explain:

Would you have any hesitation in allowing this applicant to be in a living situation (24 hr/day) with your or anyone’s children? Yes No

If yes, please explain:

Please express any other comments regarding the applicant that you feel appropriate:

How do you know the applicant:
Your Name: (Required)
Position: (Required)
Company: (Required)
Email Address: (Required)
Phone: (Required)

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