Reference Form Camp Kesher Reference Recommendation Form 2020 Name of camper you are recommending* First Last Your Name* First Last Your Phone Number*How long have you known the applicant and in what primary context?*Motivation and MaturityHow would you rate this teens social maturity?* 1 - Readily views program goals above personal comfort. Happy to help other participants without being asked. Not judgemental of others. 2 - Well liked and makes friends easily. Primarily focused on him/herself and/or close friends. 3 - Does not always react appropriately to the mood of the program or sensitivity of others. Has trouble making and/or retaining friends. With staff assistance, can integrate into the group. 4 - Routinely misses social cues. Inability to consider needs or perspectives of others. Requires constant help and supervision. How would you rate this teen's emotional maturity?* 1 - Mature beyond his/her years. Has the ability to express and regulate his/her emotions. 2 - Responds to emotional situations appropriately for his/her age. 3 - Emotionally immature. 4 - Expresses emotions inappropriately. I don't know How would you rate this teen's physical capabilities?* 1 - The teen at the front of the hike. 2 - The teen who participates happily but might need some motivation. 3 - The teen who joins activities last. Might not enjoy it, but will persevere. 4 - The teens who will not be able to complete the activity in time with the group/physically unfit/overly negative. I'm not sure. How would you rate this teen's motivation? 1 - Actively participates in all programs and engaged in discussions. 2 - Attends programming willingly. Engages sporadically. Does not distract or disrupt regardless of who is running the program. 3 - Easily influenced by the environment, both for positive and negative outcomes (Example: Peers/Relationship with staff running program) 4 - Actively disruptive and avoids attending programming. Behavioral ConcernsTo your knowledge, has the applicant been involved in any incident involving drugs, alcohol, smoking or inappropriate behavior?* Yes No To your knowledge, has the applicant been expelled from any school, camp or any other program?* Yes No Do you think this teen will positively add to the Camp Kesher experience - will it be beneficial for them as well as for the other teens involved?* Yes No Do you recommend that this teen should attend Camp Kesher? Yes No Is there any additional information you would like us to be aware of?
