References Play Pause Unmute Mute References of Junior Counselor and Cabin Leader Applicants ReferencesAn applicant has referred you to complete a Camp Courage Reference Form for our Junior Counselor or Cabin Leader programs. These programs support our mission of providing a free, meaningful, summer camp experience for children with cancer, childhood cancer survivors, and their siblings. Your answers to the following questions will help us select individuals who can contribute to a safe, supportive, and positive camp environment. Thank you for your time and insight!Please select which program you are completing a reference form for. *Select a ProgramJunior Counselor (age 16-18)Cabin Leader (age 18+)First Name *JC/CL Applicant NameLast Name *JC/CL Applicant NameFirst Name *Reference NameLast Name *Reference NameEmail Address *Reference EmailPhone *Reference NumberHow long have you known the applicant? *Relationship to applicantPlease rate the applicant in the following areas:Sense of Responsibility and Dependability *SelectExcellentGoodFairPoorUnable to answerMaturity and Judgement *SelectExcellentGoodFairPoorUnable to answerAbility to follow rules and accept feedback *SelectExcellentGoodFairPoorUnable to answerAbility to work effectively as part of a team *SelectExcellentGoodFairPoorUnable to answerAbility to be sensitive to diversity *SelectExcellentGoodFairPoorUnable to answerCommunication skills with peers and supervisors *SelectExcellentGoodFairPoorUnable to answerAbility to empathize *SelectExcellentGoodFairPoorUnable to answerAbility to interact positively with children *SelectExcellentGoodFairPoorUnable to answerAbility to navigate through and manage stressful situations *SelectExcellentGoodFairPoorUnable to answerOverall trustworthiness in an outdoor camp environment *SelectExcellentGoodFairPoorUnable to answerPlease describe the applicant's greatest strength's for this role: *In what areas might the applicant benefit from additional support or supervision from our staff? *Any additional comments about this applicantToday's Date *Signature *Start signing your signature hereYour browser does not support e-Signature field.Send Message