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Staff Reference Form

This applicant has applied for a position with Camps at Trusted Parents, a summer program for children with special needs. Since the candidate is going to be working with children, we feel it is of the utmost importance to screen each candidate extensively. We would be very grateful if you could take a few minutes to answer the following questions so that we may ensure a safe, happy, and healthy environment for our campers.

Please check the degree to which the applicant demonstrates the following qualities.

Name of Perspective Employee

Demonstrates the willingness to learn
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Ability to express self
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Ability to organize responsibilities and tasks
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Reliability and promptness in handling tasks.
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Punctuality and regularity in attendance.
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Ability to function as part of a team.
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Ability to relate well to co-workers
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Degree of flexibility and ability to adapt.
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Ability to accept evaluation of performance.
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Handles stressful situations successfully.
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Demonstrates understanding of children
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Demonstrates understanding of special needs children
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Demonstrates enthusiasm and creativeness.
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Demonstrates efficiency in routine matters
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Ability to relate and give guidance to children.
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Maintains confidentiality of information.
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Has a positive attitude and is pleasant.
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Does the applicant accept extra duties willingly?
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Would you trust this person to care for your child or a child to whom you know?
Would you re-employ this person?
My contact wih the applicant is/was:
Information given on the applicant is based on (checked all that apply)
Have you observed this person with children?
Do you have any rservations about this person working with children?

Thanks for submitting!

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