YMCA Camp Kern Reference Form
This individual has applied for the Counselor in Training program at YMCA Camp Kern, a year-round resident camp located in Southwestern, Ohio. We would greatly appreciate your honest and candid evaluation of this individual. This information will be held in the strictest possible confidence. Processing of the candidate's application will not continue without YMCA Camp Kern receiving this reference.

All YMCA Camp Kern CIT's live and work with children of all ages from diverse backgrounds with a variety of abilities. They must be excellent role models whom parents would want their children to emulate. 

If you have any questions, please feel free to call us at 513-932-3756. We thank you for your assistance in helping us choose the best role models and caregivers for our campers. 
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Applicant's Name *
Your Name *
Today's date *
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Position *
Phone Number *
Please describe the number of years you have known the applicant, the nature of your contact, and the capacity in which you know the applicant. *
Please check the box that best applies to the applicant:
How extensive has your contact been with this person? *
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Is this person able to work well with many types of people? *
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Is this person responsible? *
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Does this person work well with little or no supervision? *
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Does this person accept criticism well? *
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Does this person gather ample information before reaching a decision? *
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Does this person display YMCA four core values of Caring, Honesty, Respect, and Responsibly? *
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Is this person willing to go the extra miles? *
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Would you personally be happy to have your own child under this person's direct care and influence? *
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Please explain your answer? *
Please rate the canidate in the following areas:
General Behavior *
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Comments *
Social Ability and Communication Skills *
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Comments *
Friendliness Toward Others *
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Comments *
Enthusiasm  *
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Comments *
Internal Motivation *
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Comments *
Willingness to Cooperate  *
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Comments *
Ability to Supervise Others *
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Comments *
Leadership Among Peers *
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Comments *
Teamwork *
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Comments *
Common Sense *
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Comments *
Organizational Abilities *
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Comments *
Initiative  *
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Comments *
Creativity and Imagination *
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Comments *
Trustworthiness *
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Comments *
Self-Confidence *
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Comments *
Emotional Control *
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Comments *
Dependability *
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Comments *
Conscientious Worker *
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Comments *
Time Efficiency  *
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Comments *
Consideration of Others *
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Comments *
Cleanliness *
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Comments *
Additional comments that will help give a clear picture of this candidate's character and suitability for a Counselor in Training position: *
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