Outdoor School Reference Form

Confidential Staff Reference Form

An applicant who is applying for a seasonal instructor position with The Outdoor School has named you as a personal reference. The Outdoor School is an outdoor education facility that focuses on hands-on experiential educational and outdoor courses, and services children primarily in the 4th through 9th grades (ages 9-15). Instructor responsibilities include teaching pre-approved curriculum, facilitating teambuilding and high ropes courses, and conducting evening activities and games. Personal qualifications for instructors include a love for children, desire to teach in the outdoors, self-motivation, flexibility, demonstrated character, and the ability to work with other staff members as a team.

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* 1. Applicant Name

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* 2. Your Name

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* 3. Address

Street Address

City

State

Zip

Work Phone Number

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* 4. May this reference may be released to the applicant upon request?

Yes

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* 5. Details

In what capacity have you known the applicant?

For how long?

How well do you feel you know him or her?

If as an employer, would you re-hire the applicant?

Why or why not?

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* 6. Character Evaluation

Almost always seems happy

Seems to have self-confidence

Has a genuine interest in people

Drinks to excess at times

Uses illegal drugs

Seems to enjoy dissension

Does not make a first impression, but wears well

Discusses job problems with everyone

Talks to supervisor about job problems

Finds change difficult

Gets angry easily - loses temper

Tends to be dictatorial

Seems to be self-centered

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* 7. Please rate the applicant with respect to the following:

	Outstanding	Average	Poor	Don't Know
Responsible	Responsible Outstanding	Responsible Average	Responsible Poor	Responsible Don't Know
Congenial	Congenial Outstanding	Congenial Average	Congenial Poor	Congenial Don't Know
Teachable Spirit	Teachable Spirit Outstanding	Teachable Spirit Average	Teachable Spirit Poor	Teachable Spirit Don't Know
Flexibility	Flexibility Outstanding	Flexibility Average	Flexibility Poor	Flexibility Don't Know
Energy & Enthusiasm	Energy & Enthusiasm Outstanding	Energy & Enthusiasm Average	Energy & Enthusiasm Poor	Energy & Enthusiasm Don't Know
Responsible in emergency	Responsible in emergency Outstanding	Responsible in emergency Average	Responsible in emergency Poor	Responsible in emergency Don't Know
Positive role model	Positive role model Outstanding	Positive role model Average	Positive role model Poor	Positive role model Don't Know
Ability to speak in front of people	Ability to speak in front of people Outstanding	Ability to speak in front of people Average	Ability to speak in front of people Poor	Ability to speak in front of people Don't Know
Follows through on responsibilities	Follows through on responsibilities Outstanding	Follows through on responsibilities Average	Follows through on responsibilities Poor	Follows through on responsibilities Don't Know
General disposition	General disposition Outstanding	General disposition Average	General disposition Poor	General disposition Don't Know
Acceptance of supervision	Acceptance of supervision Outstanding	Acceptance of supervision Average	Acceptance of supervision Poor	Acceptance of supervision Don't Know
Appearance	Appearance Outstanding	Appearance Average	Appearance Poor	Appearance Don't Know
Ability to lead small group discussions	Ability to lead small group discussions Outstanding	Ability to lead small group discussions Average	Ability to lead small group discussions Poor	Ability to lead small group discussions Don't Know
Makes decisions/takes initiative	Makes decisions/takes initiative Outstanding	Makes decisions/takes initiative Average	Makes decisions/takes initiative Poor	Makes decisions/takes initiative Don't Know
Sense of humor	Sense of humor Outstanding	Sense of humor Average	Sense of humor Poor	Sense of humor Don't Know

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* 8. Please rate the applicant with respect to the following:

	Yes	No
In your opinion, is the applicant physically able to carry out an active and strenuous job for 16 hours a day?	In your opinion, is the applicant physically able to carry out an active and strenuous job for 16 hours a day? Yes	In your opinion, is the applicant physically able to carry out an active and strenuous job for 16 hours a day? No
Is the applicant's character such that his/her influence on children and other staff members would be desirable?	Is the applicant's character such that his/her influence on children and other staff members would be desirable? Yes	Is the applicant's character such that his/her influence on children and other staff members would be desirable? No
Do you consider the applicant to have good interpersonal and communication skills?	Do you consider the applicant to have good interpersonal and communication skills? Yes	Do you consider the applicant to have good interpersonal and communication skills? No
I recommend this applicant for a position with The Outdoor School.	I recommend this applicant for a position with The Outdoor School. Yes	I recommend this applicant for a position with The Outdoor School. No