Pastoral Reference

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    Name of Applicant
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    Objective Evaluation

    Under each general heading, select the phrase that most accurately describes the applicant’s habitual behavior with regard to that specific trait. Please remember that it will be the truly exceptional person that ranks high in all categories.

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    How well is the applicant able to direct and influence others?
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    How responsible is the applicant?
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    How does the applicant demonstrate a lifestyle committed to spiritual growth and integrity?
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    How well does the applicant control emotions?
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    Objective Rating

    With “1” as the lowest or poorest end of the scale and “4” as the highest or best, please select the appropriate number.

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    Teachability
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    Ability to follow instructions
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    Outgoing
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    Work with children/youth
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    Fulfilling obligations
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    Sense of humor
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    Temper control
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    Enthusiasm
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    Trustworthiness
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    Tactfulness
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    Leadership ability
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    Friendly
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    Narrative Report

    Please state briefly specific occurrances in which you have observed the applicant’s behavior as it applies to any of these items. If you lack personal knowledge on a given topic, please say so.

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    1. How long have you known the applicant?
    In what capacity?
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    2. Would you be willing to place your child under the applicant's direct influence and care?
    Yes
    No
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    Please Explain
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    3. Dependability. Can he/she be relied upon? Does this person weaken in absence of supervision?
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    4.
    I recommend
    I do not recommend
    this person for a volunteer counseling position.
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    5. Please provide any additional comments you feel will help us consider this applicant.
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    If you feel there is additional information that would be best communicated over the phone; please check this box. A Crystal Springs Baptist Camp representative will contact you.
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    Signature
    Signature Date
    Phone
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