ࡱ> EGD Dbjbj &:jjl$ $ $ $ <` $ | | | | (T$  "  | | MN  | |  {{| 09,]<$ j{{d0{LL{ Girl Scouts Of The Huron Valley Council Camp Linden PO BOX 969, Ann Arbor MI, 48106 (734)971-8800 or (800)497-2688 FAX (734)971-2160  HYPERLINK "mailto:jmaddock@gshvc.org" jmaddock@gshvc.org  HYPERLINK "http://www.gshvc.org" www.gshvc.org Confidential Reference for Summer Camp Staff  Applicant's Name  FORMTEXT       Position Applying For  FORMTEXT       I authorize the release of all information that this reference may have about me and release them from all liability for doing so. Applicant Signature FORMTEXT      Date FORMTEXT       Electronic Signature The person named above has applied for a summer camp position with the Girl Scouts of the Huron Valley Council. Because the applicant will be working closely with children, it is important that we have a comprehensive understanding of the applicants abilities, background and character. All information provided is confidential. Camp staff will live in an outdoor setting, working with or for girls age 6 through 17. The summer employment runs 6-8 weeks in a 24-hour residential setting. Each staff must be able to work and live in harmony with other adults on the staff team. The ability to deal with a variety of challenging and ever changing environments is a must. Camp staff in leadership positions help campers in camp to have fun while learning new skills, increasing their abilities to work together, managing their own activities and developing values in a safe and caring environment. The Girl Scouts of the Huron Valley Council is looking for staff who can demonstrate the following: Positive role modeling for children Ability to live and work in an outdoor setting Communicate effectively with supervisors and peers Share and teach skills to children Demonstrate enthusiasm and love for life Be a team player Express sensitivity to cultures different from their own Ability to adjust any personal habits and behavior, as necessary, to conform to the standards of Girl Scouts of the Huron Valley Council and the Girl Scouts of the United States of America. PLEASE COMMENT ON THE FOLLOWING: 1. For how long and in what capacity have you known the applicant?  FORMTEXT       2. What skills do you think the applicant has to contribute?  FORMTEXT       3. How well does the applicant accept direction and supervision?  FORMTEXT       4. Are there any known factors that might limit the applicant s effectiveness?  FORMTEXT       5. How well do you think the applicant will perform in a 24-hour, six- to eight-week communal outdoor living situation that deals with children on a continuous basis?  FORMTEXT       6. Please rate the following on a scale of 0-3: 0 = Don t Know 1 = Superior 2 = Average 3 = Poor PERSONALITY CHARACTERISTICS WORK PERFORMANCE Emotional Maturity  FORMTEXT   Flexibility  FORMTEXT   Social Awareness  FORMTEXT   Ability to work with peers  FORMTEXT   Tact, friendliness  FORMTEXT   Ability to contribute to morale  FORMTEXT   Initiative  FORMTEXT   Creative thinking  FORMTEXT   Cooperativeness  FORMTEXT   Resourcefulness  FORMTEXT   Responsibility  FORMTEXT   Enthusiasm  FORMTEXT   Willingness to learn  FORMTEXT   Responsibility(for equipment)  FORMTEXT   Adaptability to work environment  FORMTEXT   Skills  FORMTEXT   General appearance, neatness  FORMTEXT   Acceptance of supervision  FORMTEXT   Leadership ability  FORMTEXT   Energy, endurance  FORMTEXT   7. Please comment on the applicant's communication skills  specifically confrontation, talking in front of groups of children or adults, teaching skills, and the ability to listen.  FORMTEXT       8. Would you recommend this applicant for a position in a Girl Scout camp?  FORMCHECKBOX  No  FORMCHECKBOX  Yes Thank you for your time and cooperation! Please complete the following information and RETURN THIS FORM TO THE ADDRESS BELOW WITHIN TEN DAYS OF RECEIPT. Date FORMTEXT  DATE 1/23/20081/23/2008 Electronic Signature FORMTEXT       Title  FORMTEXT       Address FORMTEXT       City, State, Zip FORMTEXT       Day Phone FORMTEXT       Evening Phone  FORMTEXT       (34$%&'(9:DE  :<PRT^`dnྵ{xCJj>*CJUjB>*CJU>*CJj>*CJUCJj>*CJUmHnHu>*CJ CJOJQJ^J5CJj5CJU 0J5CJj5CJUj5CJU5CJCJ(OJQJ^J OJQJ^J5*(4T%&(bdln*+w x  ($(a$ $( $((($(a$ $a$D*M v x  `b <>RTV`bd  ھڵڲ֤֘֌րj>*CJUj>*CJUj>*CJUj*>*CJU5CJCJOJQJ^J 5CJ\ 6CJ]j>*CJU>*CJCJj>*CJUmHnHuj>*CJUj.>*CJU2 ? r  O  b<dfhj024 (^`( ",.04&(*,.HJ^`bdf*,@BDFHjX>*CJUj>*CJUjh>*CJUj>*CJUjx>*CJUj>*CJUCJOJQJ^JCJ>*CJj>*CJUmHnHuj>*CJU74h&"^02 #@@@@( @@( p.@(  "#&(*+.(( "$HJ^`bdf NPdfh־ֲ֦֚֎ւj >*CJUj >*CJUj( >*CJUj >*CJUj8 >*CJUj>*CJUjH>*CJU>*CJCJj>*CJUmHnHuj>*CJUj>*CJU3hjl&(*,.>@TVXZ\  68LNPRTz|j`>*CJUj >*CJUjp >*CJUj >*CJUj >*CJUj >*CJUj >*CJU>*CJCJj>*CJUj>*CJUmHnHu4  ",.p  246@BRͼƸͮƸͪ|j&>*CJUj>*CJUj:>*CJU>*CJmHnHu5CJjCJU8CJjNCJU jCJUCJj>*CJUmHnHuj>*CJU>*CJj>*CJUCJOJQJ^J02468DzBD (( (( H((  ((( RThjlvx024>@Dj>*CJUj>*CJUj>*CJUCJj>*CJUmHnHuj>*CJU>*CJj>*CJU$&P1h/ =!"#u$%DyK yK 4mailto:jmaddock@gshvc.orgDyK yK ,http://www.gshvc.org/vD2Text57vD2Text58vD2Text73DText59M/d/yyyyvDText60vDText61vDText62vDText63vDText64xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650xDText650vDText66vDeCheck24vDeCheck25vDText67vD2Text74vD2Text69vDdText70vDdText71DText72 ###-###-####DText72 ###-###-#### iD@D Normal$CJOJQJ^J_HaJmH sH tH L@L Heading 3$$@&a$5>*CJOJQJ^JaJJ @J Heading 9 $$(@&a$5OJQJ^JaJ<A@< Default Paragraph Font@Q@@ Body Text 3 $( 5CJ\.U@. 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