How long have you known the applicant? - Clover Sites
Reference Form for His Hill Ranch Camp His Hill Attn: Volunteer Application Process P.O. Box 9 Comfort, TX 78013 This must be completed by a pastor, employer, youth director, or friend not associated with His Hill, who has known you for at least one year and is over the age of 18. No family members please. Confidential Reference Form-Please Print Clearly Reference for: His Hill Ranch Camp is an independent, Christian youth camp located 45 miles northwest of San Antonio. The above has applied for the position of: Name: How long have you known the applicant? What is your relationship?
I know the applicant: (please circle)
extremely well
How long has the applicant been a Christian?
rather well
casually
The applicant shows particular ability in: Applicant’s home church involvement: Applicant’s ministry involvement:
Agree/Disagree/Not Sure
The applicant is the kind of person who is more in need of encouragement than he/she is able to encourage. The applicant is a violent person.
The applicant is known to use offensive language when upset. The applicant is able to work with children in a gentle manner without using physical force. The applicant is comfortable with children. I have no reservations concerning the applicant’s honesty and integrity. The applicant has an unhealthy attachment to members of the opposite sex, which causes concern. The applicant has a relationship, which might be construed as homosexual in nature. I would entrust my own children to the direct charge and influence of the applicant.
Please rate the applicant in each of the following areas. Circle the number, which in your opinion best represents where the applicant fits on the scale.
Personality Disposition Committed Believer Relationships Reputation in the community Self-Confidence Emotional Stability Dependability Work Ethics Ability to work independantly Judgment Respect for those in authority Obedience to those in authority Teachable Leadership Initiative Able to handle details Personal Appearance and Grooming
withdrawn 1 2 solemn
3
4
1 2 3 uncommitted 1 2 abrasive
4
3
4
3
4
3
4
1 2 unstable
3
4
3
4
1 2 lazy
3
4
3
4
3
4
3
4
1 2 poor
1 2 insecure
1 2 irresponsible
1 2 dependant 1 2 poor
1 2 disrespectful 1 2 disobedient
3
1 2 rebellious
3
1 2 never leads 1 passive
2
1 2 unorganized 1 2 unkempt 1
Name: Address: □ I recommend unreservedly □ I recommend with reservations □ I do not recommend
Signature:
2
3
3
3 3
5
5
5
4 4 4 4
don’t know
□
6 cheerful
don’t know
□
6 committed
don’t know
□
6 congenial
don’t know
□
6 respected
don’t know
□
6 secure
don’t know
□
6 stable
don’t know
5 6 □ highly dependable don’t know 5
5
5
5
5
□
6 industrious
don’t know
□
6 independant
don’t know
6 □ very discerning don’t know
6 □ very respectful don’t know 6 □ very obedient don’t know
5 6 □ highly responsive don’t know
4
5
4
3
5
4
5
outgoing
5
□
6 leader
don’t know
5 6 □ takes initiative don’t know 5 5 5
6 □ detail oriented don’t know 6 neat 6
□
don’t know
□
Phone: Please feel free to explain any answer or add additional comments on a separate page.
Date:
His Hill Ranch Camp P.O. Box 9 Comfort, TX 78013 830-995-3388 fax 830-995-2050 [email protected] www.hishill.org
I know the applicant: (please circle)
extremely well
How long has the applicant been a Christian?
rather well
casually
The applicant shows particular ability in: Applicant’s home church involvement: Applicant’s ministry involvement:
Agree/Disagree/Not Sure
The applicant is the kind of person who is more in need of encouragement than he/she is able to encourage. The applicant is a violent person.
The applicant is known to use offensive language when upset. The applicant is able to work with children in a gentle manner without using physical force. The applicant is comfortable with children. I have no reservations concerning the applicant’s honesty and integrity. The applicant has an unhealthy attachment to members of the opposite sex, which causes concern. The applicant has a relationship, which might be construed as homosexual in nature. I would entrust my own children to the direct charge and influence of the applicant.
Please rate the applicant in each of the following areas. Circle the number, which in your opinion best represents where the applicant fits on the scale.
Personality Disposition Committed Believer Relationships Reputation in the community Self-Confidence Emotional Stability Dependability Work Ethics Ability to work independantly Judgment Respect for those in authority Obedience to those in authority Teachable Leadership Initiative Able to handle details Personal Appearance and Grooming
withdrawn 1 2 solemn
3
4
1 2 3 uncommitted 1 2 abrasive
4
3
4
3
4
3
4
1 2 unstable
3
4
3
4
1 2 lazy
3
4
3
4
3
4
3
4
1 2 poor
1 2 insecure
1 2 irresponsible
1 2 dependant 1 2 poor
1 2 disrespectful 1 2 disobedient
3
1 2 rebellious
3
1 2 never leads 1 passive
2
1 2 unorganized 1 2 unkempt 1
Name: Address: □ I recommend unreservedly □ I recommend with reservations □ I do not recommend
Signature:
2
3
3
3 3
5
5
5
4 4 4 4
don’t know
□
6 cheerful
don’t know
□
6 committed
don’t know
□
6 congenial
don’t know
□
6 respected
don’t know
□
6 secure
don’t know
□
6 stable
don’t know
5 6 □ highly dependable don’t know 5
5
5
5
5
□
6 industrious
don’t know
□
6 independant
don’t know
6 □ very discerning don’t know
6 □ very respectful don’t know 6 □ very obedient don’t know
5 6 □ highly responsive don’t know
4
5
4
3
5
4
5
outgoing
5
□
6 leader
don’t know
5 6 □ takes initiative don’t know 5 5 5
6 □ detail oriented don’t know 6 neat 6
□
don’t know
□
Phone: Please feel free to explain any answer or add additional comments on a separate page.
Date:
His Hill Ranch Camp P.O. Box 9 Comfort, TX 78013 830-995-3388 fax 830-995-2050 [email protected] www.hishill.org
