Applicant Name:

Reference Name:

Reference Phone #:

Reference Email:

How long have you known the applicant?

In what capacity have you known the applicant?

Communication Skills

Showing Initiative

Dependability

Energy/Enthusiasm

Teachable

Respect for Authority

Leadership Skills

Organization Skills

Relationship Skills

Conflict Resolution Skills

Ability to Cope with Stress

Responsibility

What is the applicant's stongest attribute?

What is the applicant's weakest attribute?

What concerns would you have with the applicant working 24 hour days with kids?

Why would you hire the applicant to work with kids?

Please let us know any additional comments/concerns you might have: