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staff reference form 

Please have this reference form submitted by an employer, teacher, or other professional who knows you. Each staff member is required to submit 3 written references.

Since we wish to hire people with proven ability and emotional stability, we would appreciate your frank opinion. We wish to thank you for your cooperation and assure you that your information will be held in the strictest confidence.

If you prefer you may dowload this form as a PDF, print it and fax it back to our office.
PDF - 
Adobe  Staff Reference Form


Please note: You will need the Acrobat® Reader to view these forms. If you don't have the plug-in, you may download it from the Adobe Web site.


Applicant's Name: (required):

Your Name: (required):

Your Email: (required):

Your Phone: (required): Best Time to Call:



How long and in what capacity have you have known the applicant?
How would you characterize his/her moral character (integrity, honesty, values, etc.)?
In your opinion, would this person be a great role model for girls ages 7-15?
Is this person's maturity on par with his/her peers? How does he/she communicate with others?
How would you describe his/her ability to handle stress? Conflict?
What would you consider to be a stand-out strength for this person?
What is one area in which you would like to see some growth or development?
Considering the applicant will be working with children, please add any additional comments of support or caution. (In particular, we would like to know about – and would hold in the strictest confidence – any concerns you may have regarding his/her appropriateness with children, history of illegal or destructive behavior, or possible abuse of alcohol or drugs.)
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Looking for a boys' camp?
Check out our brother camp
Camp Cobbossee
     only 1/2 mile from Kippewa on Lake Cobbosseecontee
1-800-KIPPEWA
(547-7392)
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