Texas A&M-Commerce
Outdoor Adventure Center
Outdoor Staff REFERENCE FORM
Reference Name: _________________________________________________
Address: ________________________________________________________
Home Phone #: ___________________ Work Phone #: ___________________
Dear ____________________________:
The following individual has applied to work as a part of the Outdoor Adventure Program at
Texas A&M-Commerce. We are requesting that you complete the following questions in
reference to your knowledge and relationship to the applicant. The information you share is
confidential and will only be used as part of our screening process.
Applicant’s Name: ________________________________________
1. What is your connection with the applicant? (Circle those that apply.)
Friend
Family
Employer
Other: ______________________
2. Have you ever observed the applicant leading or teaching a group before? Yes or No
3. What are some of the applicant’s strengths and talents? ________________________
________________________________________________________________________
________________________________________________________________________
4. Please use the rubric below to score the applicant on the following skills.
1= Unable to perform the skill
2= Able to perform the skill w/ difficulty
3= Able to perform the skill well
4= Able to perform the skill at an advanced level
Communication skills
Decision-making skills
Leadership skills
Listening
Dependable
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
Honesty
Working with others
Leading others
Problem-solving skills
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5. Is there anything that you are aware of that would interfere with the applicant’s ability
to lead a group? ____________________________________________________________
6. Would you recommend this applicant to work with minors? If not please explain.
___________________________________________________________________________
___________________________________________________________________________
7. Personal Comments or Concerns: _____________________________________________
__________________________________________________________________________
Reference’s Signature: __________________________
Date: ________________
Please Mail to : Texas A&M-Commerce
Morris Recreation: Outdoor Adventure Center
PO Box 3011
Commerce, Texas 75429-3011
Justin.Crossland@tamuc.edu
Rev. 8/6/2015