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

First name

Last name

Would you trust this person to care for your child or a child to whom you know?

Yes

No

Would you re-employ this person?

Yes

No

How long have you known the applicant?

My contact wih the applicant is/was:

Almost daily

Frequently

Infrequently

Information given on the applicant is based on (checked all that apply)

Co-worker

Worked under my supervision

Student in my class

Other

Please indicate other:

Have you observed this person with children?

Yes

No

Comments

Please share with us anything about this person that will assist us in our hiring decision.

Do you have any rservations about this person working with children?

Yes

No

If yes, please explain.

Reference Full Name (Individual submitting this form)

Reference Position/ Job Title

Company/College/School

Work Address

Organization's Website

The most convenient time to contact you should we need to verify the information above is between (ex. 11:00am-2:00pm)

Best Phone #:

Thanks for submitting!

980-229-7253

Camps at Trusted Parents

Staff Reference Form

Name of Perspective Employee

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