Ketchikan•Gero•Kanayama Chaperone Candiates Recommendation Question Title * 1. Chaperone Applicant Name: Name: The above applicant is applying to be a part of the Ketchikan-Kanayama Student Exchange. He/She would like your evaluation of how you think he/she will fit in with the group traveling. This information will be treated as CONFIDENTIAL and not shared with the applicant. Please answer honestly. Thank you for your help in the selection process Question Title * 2. How long have you known this applicant? Question Title * 3. In what capacity? Employer Family Friend Co-worker Question Title * 4. What characteristics or attributes best describe this applicant? Question Title * 5. In what area(s) is this applicant most exceptional? Question Title * 6. How well do you feel the applicant participates within a group? Very Well Well OK Not Well Question Title * 7. How well does this applicant communicate with others? Very Well Well OK Not Well Question Title * 8. Is this candidate trustworthy? Yes No Question Title * 9. Comment on trustworthiness: Question Title * 10. Does this candidate respect authority? Yes No Question Title * 11. Comment on respecting authority: Question Title * 12. How well does this candidate tolerate difference and respect others? Very Well Well OK Not Well Question Title * 13. Comment on tolerating differences and respecting others: Question Title * 14. Is this candidate reliable and prompt? Yes No Question Title * 15. Does this candidate possess leadership skills? Yes No Question Title * 16. Does this applicant make his/her own decisions despite obvious pressure from others? Yes No Most of the time Question Title * 17. Comment on decision making. Question Title * 18. Please make any other comments about your general impression of the applicant. Interpersonal Relations Question Title * 19. As you observe this applicant in relation to other people, is he/she usually Cooperative? Yes No Sometimes Question Title * 20. As you observe this applicant in relation to other people, is he/she usually Respectful? Yes No Sometimes Question Title * 21. As you observe this applicant in relation to other people, is he/she usually looked to for guidance? Yes No Sometimes Question Title * 22. As you observe this applicant in relation to other people, is he/she usually outgoing? Yes No Sometimes Question Title * 23. As you observe this applicant in relation to other people, is he/she usually outgoing? Yes No Sometimes Question Title * 24. As you observe this applicant in relation to other people, is he/she usually sensitive to others? Yes No Sometimes Question Title * 25. Comments on the above responses: How well does this applicant react to: Question Title * 26. Physical discomfort? Question Title * 27. Stress / Discomfort? Question Title * 28. A sudden change in schedule? Question Title * 29. An awkward or embarrassing situation? Question Title * 30. Would you have any reservations if this applicant were accompanying your child on an extended trip to a foreign country? Yes No Some Question Title * 31. Please make any other comments about your general impression of this applicant. Question Title * 32. Your name: Name: Phone Number: Thank youYour time and comments will help us as we make our selections for current travel group. Remember your responses are confidential. Thank your for your time. Your comments will help us as we make our selections for current travel group. All responses are confidential. Done