Maine High Adventure Katahdin Area Council, Bsa Seasonal Staff Application Page 6
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6REFERENCE QUESTIONNAIRE
Maine High Adventure, BSA
Katahdin Area Council, BSA
PO Box 1869
Bangor, ME 04402-1869
(Office) 207-949-5260
(Fax) 207-866-3283
(E-Mail)
___________________________ is applying for a seasonal position with Maine High Adventure, BSA, an advanced outdoor program
for youth and their adult leaders. The success of our program depends largely upon the quality and performance of the staff. Please be
frank and honest in your evaluation of this applicant, and then return this form to the Maine High Adventure, BSA office at the
address, fax, or E-Mail listed above. Thank you in advance for your assistance.
How long have you known this applicant? ____________________ Relationship: __________________________________________
How well do you know this applicant? ______ very well
______ well
______casually
______not well
Please CIRCLE the phrases that best describe the applicant:
APPEARANCE:
flawless
generally neat
acceptable
sloppy
DEPENDIBILITY:
exceptional
usually dependable
requires supervision
irresponsible
INITIATIVE:
self-motivated
industrious
has some drive
low
PERSONALITY:
charismatic
outgoing
pleasing
bland
COOPERATION:
inspires confidence
cooperates willingly
usually cooperative
not cooperative
LEADERSHIP:
inspirational
takes charge
team player
follower
ATTITUDE:
always enthusiastic
positive
acceptable
poor
COMMON SENSE:
always uses good
usually uses good
acceptable
poor
judgment
judgment
ORAL EXPRESSION: eloquent
good
satisfactory
poor
INTEGRITY:
always trustworthy
honest
reliable
unreliable
TEACHING ABILITY: extremely capable
experienced
limited
poor
What, in your opinion, may be this applicant’s great strength(s)?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
What, in your opinion, may be this applicant’s greatest weakness(es)?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
What is your recommendation for this applicant? ______recommend highly
______recommend
______cannot recommend
Please share any reservations you may have about your recommendation. Additional comments welcome.
Signed: _________________________________________Printed Name: ______________________________Date:_____________
Address: _________________________________________________________Phone:_____________________________________
E-Mail:_________________________________________________________May we contact you further? ______Yes ______No
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