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About the Applicant
(*) Indicates required fields
Applicant's Name:
*
How long have you known the applicant?
*
In what capacity?
Would you hire/re-hire this person?
Select One
Yes
No
Not Applicable
If no, for what reason?
Is this the type of person you would want as a counselor for a child of your own?
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Yes
No
Not Applicable
Please explain if the answer is no:
Characteristics of the Applicant
Motivation (Desire to learn):
Select One
Very ambitious
Eager
Average
Indifferent
Purposless
Enthusiasm:
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Excellent
Good
Average
Fair
Poor
Loyalty:
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Excellent
Good
Average
Fair
Poor
Emotional Maturity (self-control):
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Very Stable
Well-Balanced
Average
Below Average
Unstable
Social Acceptability (response from others):
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Sought Out
Well-liked
Accepted
Tolerated
Avoided
Tolerance:
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Excellent
Good
Average
Fair
Poor
Energy:
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Excellent
Good
Average
Fair
Poor
Responsibility:
Select One
Always Assumes
Often Seeks
Accepts
Avoids
Never Accepts
Communication:
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Excellent
Good
Average
Fair
Poor
Social Attitude (concern for others):
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Deeply Concerned
Interested
Average
Indifferent
Anti-social
Humor:
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Excellent
Good
Average
Fair
Poor
Understanding Children:
Select One
Excellent
Good
Average
Fair
Poor
Leadership:
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Always leads
Frequently Leads
Seldom leads
Follower
Negative
Ability to Accept Supervision & Guidance:
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Excellent
Good
Average
Fair
Poor
Summary:
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Outstanding
Above Average
Average
Fair
Doubtful
What are this applicant's greatest strengths? Weaknesses? What extra-curricular activities are they involved with?
To the best of your knowledge, has the applicant ever had any criminal convictions for child abuse or sexual abuse offenses?
Select One
Yes
No
To the best of your knowledge, has the applicant ever had any criminal convictions for a felony or misdemeanor?
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Yes
No
About You
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Take the First Step towards the Greatest Summer Ever!
Come share the magic of Hampton Country with your family!
Dave Skolnik & Doris Rosen
Owners & Directors
516-953-5171
Winter Phone Number
631-537-1770
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