STAFF REFERENCE FORM 2025

Pilgrim Pines Camp and Retreat Center’s mission is to invite people from their routines into opportunities to grow, experience renewal, and enjoy re-creation and relationships, so that they will experience God through Jesus Christ. Our summer staff is vital to this mission. It is our desire to hire a staff that is trustworthy and capable of caring for and discipling our campers. It is imperative that all summer staff members be positive spiritual role models for our campers.

Please evaluate the applicant as you have seen him/her in daily life, at work, or in a church setting. Your reference will be kept confidential.

Please expect a brief phone call or email from one of our staff members to confirm and follow up with any questions regarding your reference. If you have any questions, please contact us at Pilgrim Pines at 603.352.0443.

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* 1. Applicant's Name

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* 2. Your Contact Information

Name

Email Address

Phone Number

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* 3. In what capacity do you know the applicant?

Professional / Work

Academic / School

Spiritual / Church

Personal / Family

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* 4. How long have you known the applicant?

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* 5. How likely is it that you would recommend this applicant to a colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

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* 6. Please rate the applicant in the following areas:

	Excellent	Good	Average	Poor
Responsibility - diligently follows through on all tasks	Responsibility - diligently follows through on all tasks Excellent	Responsibility - diligently follows through on all tasks Good	Responsibility - diligently follows through on all tasks Average	Responsibility - diligently follows through on all tasks Poor
Integrity - consistently trustworthy	Integrity - consistently trustworthy Excellent	Integrity - consistently trustworthy Good	Integrity - consistently trustworthy Average	Integrity - consistently trustworthy Poor
Work Ethic - puts forth the extra effort	Work Ethic - puts forth the extra effort Excellent	Work Ethic - puts forth the extra effort Good	Work Ethic - puts forth the extra effort Average	Work Ethic - puts forth the extra effort Poor
Communication - articulate in all groups	Communication - articulate in all groups Excellent	Communication - articulate in all groups Good	Communication - articulate in all groups Average	Communication - articulate in all groups Poor
Leadership - leader of leaders	Leadership - leader of leaders Excellent	Leadership - leader of leaders Good	Leadership - leader of leaders Average	Leadership - leader of leaders Poor
Emotional Stability - exceptional, stable, consistent	Emotional Stability - exceptional, stable, consistent Excellent	Emotional Stability - exceptional, stable, consistent Good	Emotional Stability - exceptional, stable, consistent Average	Emotional Stability - exceptional, stable, consistent Poor
Motivation - extremely self motivated and proactive	Motivation - extremely self motivated and proactive Excellent	Motivation - extremely self motivated and proactive Good	Motivation - extremely self motivated and proactive Average	Motivation - extremely self motivated and proactive Poor
Judgement - consistently makes wise decisions	Judgement - consistently makes wise decisions Excellent	Judgement - consistently makes wise decisions Good	Judgement - consistently makes wise decisions Average	Judgement - consistently makes wise decisions Poor
Team Participation - outstanding group member	Team Participation - outstanding group member Excellent	Team Participation - outstanding group member Good	Team Participation - outstanding group member Average	Team Participation - outstanding group member Poor

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* 7. How would you describe the applicant's Christian commitment?

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* 8. Please tell us about any areas where this applicant stands out as exceptional.

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* 9. Please list any areas for improvement for this applicant.

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* 10. Is there anything that you feel we should know about this applicant as we consider him/her for employment?

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* 11. Do you have any reason to believe this applicant is not fit to work with or provide supervision to children? Are you aware of any incidents involving child abuse or neglect?

Yes

STAFF REFERENCE FORM 2025

Question Title

* 1. Applicant's Name

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* 2. Your Contact Information

Question Title

* 3. In what capacity do you know the applicant?

Question Title

* 4. How long have you known the applicant?

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* 5. How likely is it that you would recommend this applicant to a colleague?

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* 6. Please rate the applicant in the following areas:

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* 7. How would you describe the applicant's Christian commitment?

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* 8. Please tell us about any areas where this applicant stands out as exceptional.

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* 9. Please list any areas for improvement for this applicant.

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* 10. Is there anything that you feel we should know about this applicant as we consider him/her for employment?

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* 11. Do you have any reason to believe this applicant is not fit to work with or provide supervision to children? Are you aware of any incidents involving child abuse or neglect?

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* 12. If yes, please explain.