Camp Galilee Counselor Applicant 2014
Reference Form
Applicant’s Name:_____________________________________________
Reference Name:______________________________________________
Primary Phone: (______)_________________ Secondary Phone: (______)________________
Relationship to Applicant:________________________________________________________
The above named applicant is applying to become a counselor at Camp Galilee. If hired, he or she would
participate in a rigorous 8-day training in teambuilding skills, leadership of outdoor adventure activities,
conflict management, program implementation and evaluation. The counselor would then be assigned to
work particular week-long camp sessions. In coordination with an adult staff member, the counselor
would be responsible for planning and leading games, reflections, and excursions such as kayaking, rock
climbing, or overnight backpacking trips for the group of children in their care. We seek applicants with a
high level of maturity and self-confidence. Participants must also be able to actively give and receive
constructive feedback. This reference is strictly confidential and will not be seen by the applicant, so
please be honest in your responses. Thank you!
1. Please describe the nature and length of your relationship to the applicant.
2. Using the following scale, please rate the applicant:
Excellent
Good
ADAPTABILITY
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RESPONSIBILITY
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RESOURCEFULNESS
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ENTHUSIASM
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LEADERSHIP
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SENSE OF HUMOR
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PATIENCE
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COOPERATION
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INITIATIVE
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Fair
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Poor
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As a counselor, the applicant would be one of the providers of care and nurturing for a
group of 6-9 boys or girls 22 hours a day for a week at a time, and would be responsible to
help plan and lead a group of 13 boys and girls in an adventure group. They would work
closely with a resident staff person, age range from 19-25.
3. What strengths and weaknesses do you see the applicant having in this position?
Counselor Reference Form (page 2)
4. How would you feel about the applicant being responsible for caring and nurturing your
own child?
5. Have you ever seen any behavior from the applicant that would lead you to believe they
might misuse their position?
6. Any other comments you would like to share?
Thank you for taking the time to complete and return this form.
__________________________________________________
Signature
_______________________
Date
Return to:
jobs@galileetahoe.org (scanned) or mail to:
Camp Galilee
Counselor Application Reference
PO Box 236
Glenbrook, NV 89413
The priority deadline for receipt of application materials is March 15, 2014.