Covenant Pines Bible Camp Junior Staff Reference Form
The emphasis of our Junior Staff Programs (SWEAT and Jr. Counselor) is service and leadership development in a Christian environment. Please evaluate the applicant as you have seen him/her in daily life, at work, at school, and/or in a church setting. Your opinions and feedback will become part of the applicant's confidential file. Your time and effort are greatly appreciated.

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Junior Staff Applicant Name *
Reference Name *
Email Address *
Primary Phone Number *
How long have you known the applicant? *
In what capacity do you know the applicant? *
To your knowledge, has the applicant ever been charged with, convicted with, or pleaded guilty or nolo contendere to any crime during his or her life? *
To your knowledge, does the applicant demonstrate a lifestyle committed to spiritual growth and moral integrity? *
Comments
If you had a child of camper age, would you feel comfortable leaving your child in the care of the applicant? *
Comments
What would you consider to be the applicant's most outstanding characteristic or skill? *
What would you consider to be one area of personal growth for this applicant? *
Please grade the applicant to the best of your knowledge.  “1” is the lowest on the scale or “never”.  “10” is highest on the scale or “always”.  
If you are unsure, or have no knowledge of that particular category, please leave it blank.
Positive Attitude
Clear selection
Christ-like Lifestyle
Clear selection
Motivated
Clear selection
Temper Control
Clear selection
Teachability
Clear selection
Emotional Maturity
Clear selection
Leadership Ability
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Stamina
Clear selection
Dependability
Clear selection
Enthusiasm
Clear selection
Promptness
Clear selection
Follows Instructions
Clear selection
Gets along with others
Clear selection
Recommendation for a position at Covenant Pines Bible Camp*: *
Final Comments
Electronic Signature
MM
/
DD
/
YYYY
Please contact Angie Sampson with any questions or follow up.
Angie Sampson
Retreat Ministry Director
jr@covenantpines.org
(218) 768-2610
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