Serving Children with Diabetes for More than 70 Years

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Recommendation Form

Sweet Home Camp Sweeney Week 2B

Starts In

Employee Recommendation Form

Thank you for taking the time to fill out this personal recommendation form. Camp Sweeney is a camp intended specifically for children ages 5-18 with Type 1 diabetes. Designed as a behavioral modification program, Camp Sweeney helps young people avoid the long-term complications of diabetes by instilling in them the self-confidence and medical knowledge they need to live longer, healthier lives. Each year we make a concerted effort to hire individuals who have a strong desire to serve others and make a difference in the life of a child. With this in mind, please complete the following form to the best of your knowledge regarding the applicant. Please be as objective as possible. Your responses will not be shown to the applicant.
Reference for:*
Name of applicant
First Last
Nature of Relationship with Applicant*
- Teacher/Instructor/Professor
- Employer or Former Employer
- Professional
- Family
How long have you known this person?*

Tell Us About the Applicant's Traits*

Please rate the applicant in the following categories on a scale of 1-5 (1=lowest, 5=highest). Select N/A if you are completely unsure or if you have no prior knowledge in a particular area.

	1	2	3	4	5	N/A
Follows Instruction
Promptness
Fulfills Obligations
Emotional Self Control
Good Judgment
Maturity
Friendliness
Integrity
Trustworthy
Gets Along with Others
Works Well with Children
Mission Oriented
Positive Attitude
Good Work Ethic

Additional comments about the applicant's personality.*
Camp Sweeney's first priority is the safety and well-being of our campers and staff members.
To your knowledge, has the applicant ever been accused of physically, sexually, or emotionally abusing, molesting, or having otherwise inappropriate contact with a child or an adult ?*
- Yes
- No
To your knowledge, has the applicant ever been convicted of a crime ?*
- Yes
- No
Please explain:*
Based on your knowledge of this applicant how would you recommend them for employment at Camp Sweeney?*
- Strongly Recommend
- Would Recommend
- Recommend with Reservations
- Would Not Recommend
What specific reasons would you give for hiring or not hiring the applicant?*
Information about person filling out this form.
Name*
First Last
Position
Organization/Company
Cell Phone*
Email*
Date*
Date Format: MM slash DD slash YYYY
Certification*
- I certify that the above statements are true to the best of my knowledge.