Wanakee - 2022 Reference Check Form

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Thank you for your willingness to provide a reference on behalf of a prospective Wanakee staff member or volunteer! Your insights help us ensure that our campers (ages 2-18) have a positive, safe experience this summer.

Email *

Your Name *

Wanakee Staff/Volunteer Applicant's Name *

What is your relationship to the applicant? *

How long have you known the applicant? *

How well do you know the applicant? *

How would you describe the applicant? *

How would you describe the applicant's ability to relate to youth/children? *

How would you describe the applicant's leadership abilities? *

How would you describe the applicant's ability to relate to adults/colleagues? *

Do you know of any characteristics that would negatively affect the applicant's ability to work with children/youth? If so, please describe. *

This applicant will be working in an environment that will place them as a role-model for children. In what ways will the applicant serve as a role model in action and word? *

Do you have any knowledge that the applicant has ever been convicted of a crime? If so, please describe. *

Are there any other comments you would like to make? *

Electronic Signature (By typing my name here, I am acknowledging that all of the above information is accurate to my knowledge and the electronic signature is the legally binding equivalent to my handwritten signature.) *

Date Completed *

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Send me a copy of my responses.

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