Confidential Staff Reference Form

Each person applying for a summer staff position at Ponderosa Bible Camp is required to have at least 3 references (adults) complete and submit this form.

This form needs to be completed by an adult who is NOT RELATED to the applicant.  

We prefer that this form be completed by a Pastor, Youth Pastor, Church Leader, Employer, or Teacher who is significantly acquainted with the applicant.

Would you assist us by prayerfully and carefully answering the following questions?  If you are not sufficiently acquainted with the applicant, please let the applicant know that you are not comfortable submitting this reference for them.  This form will be submitted directly to Ponderosa Bible Camp and will not be seen by the applicant, therefore we ask that you be as open and honest as you can.  If you have any questions or concerns please call Jeff Nelson, Executive Director, Ponderosa Bible Camp, at 256-634-4397.  Thank you!

Name of Applicant to whom this reference applies: * Position this applicant desires * TEAM Member SALT Member Camp Counselor Lifeguard How long have you known this applicant? * In what capacity? * Are you related to this applicant? * Yes No Is he/she inclined to received instruction? * Yes No Is he/she inclined to yield to discipline? * Yes No Does he/she work well with others? * Yes No Do you have any reservations about this person working with children/youth? * Yes No Does he/she have any significant limitations in the physical, mental, emotional, or social realms? If so, please explain: * Do you consider this person to have a fun outgoing personality? * Have you observed anything that would be questionable in his/her moral life? If so, please explain: * Would you recommend this applicant be accepted by Ponderosa Bible Camp * Not at all Questionably Willingly Enthusiastically PERSONALITY TRAITS YOU HAVE OBSERVED IN THIS APPLICANT   Spiritual Life * No interest in spiritual growth Small evidence of spiritual growth Average spirituality Shows growth and separated living Deeply spiritual Purposefulness * Aimless trifler Vacillating in purpose Average or potentially purposeful Self-directed Well-formed purpose Initiative * Requires constant supervision Requires some direction Average or occasional initiative Shows good initiative Anticipates needs; resourceful Responsibility * Irresponsible; careless shows some dependability Usually reliable Thoroughly dependable Capable of much responsibility Industry * Difficult to handle Needs prodding Performs assigned tasks Goes beyond what is required; cooperative Seeks additional work Influence on others * Detrimental influenced Passive, no positive influence Varying influence Consistently good influence Unusually wholesome influence Acceptance by others * Avoided by others Just tolerated by others Liked by others Well-liked by others Sought after by others Leadership * Always a follower Tries, but usually fails at leadership Assumes occasional leadership Good leadership Inspiring and successful leader Emotional Qualities * Too emotional and apathetic Excitable or unresponsive Usually well-balanced Consistently well-balanced Of unusual emotional stability Servant Attitude * Appears lazy & selfish Often seeks to be served - often selfish Average Usually seeks to serve others Goes the extra mile to serve - very unselfish Name of adult reference completing this form * E-mail Address: * Association/Relationship to Applicant * Reference Phone Number * Reference Mailing Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, DC West Virginia Wisconsin Wyoming --Territories-- American Samoa Federated States of Micronesia Guam Midway Islands Puerto Rico U.S. Virgin Islands * Required