Please complete an online reference form for a potential employee.Applicant Full Name*First NameLast NameYour Name*First NameLast NameYour E-mail*Your Phone Number*Area CodePhone NumberYour Cell Number*Area CodePhone NumberRelationship with Applicant*How long have you known him/her?*Please indicate the appropriate rating for the following areas:MATURITY*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageCHARACTER*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageDEPENDABILITY*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageLEADERSHIP*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageMOTIVATION*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageJUDGEMENT*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageCOMMUNICATION*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageSKILLS*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageENTHUSIASM*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageWORK ETHIC*-- PLEASE SELECT --SuperiorAbove AverageAverageBelow AverageHow would you describe the applicant’s personal characteristics? (I.e. mature, withdrawn, shy, assertive, etc.)*How would you rate the applicant’s ability to work with other staff members?*How does the applicant deal with criticism? Direction?*From your knowledge, how well does he/she relate to children?*Would you want this person to be your child's counselor?*-- PLEASE SELECT --YesNoWhy or why not?*To your knowledge, has the applicant suffered any significant physical or nervous difficulties which would interfere with his/her work with children?*-- PLEASE SELECT --YesNoEvaluate the following statement: To your knowledge, has the applicant ever exhibited abusive or sexual improper tendencies towards others or has he/she ever been convicted of a felony or misdemeanor?*-- PLEASE SELECT --YesNoSubmitShould be Empty: This page uses TLS encryption to keep your data secure.