CAMP AMNICON
8450 E Camp Amnicon Rd
South Range, WI 54874
Phone: (715) 364-2602
Fax: (715) 364-2652
amnicon@usa.net

AMNICON
2008 SUMMER STAFF REFERENCE FORM
Fill out the form online and press the "Submit…" button at the bottom of the page.
(Or, print out and return the completed form to the camp via mail or fax.)


Name of Applicant:
Seeking the Position of:


Amnicon is a Lutheran Camping Ministry offering wilderness high adventure programs for mostly Jr. and Sr. high aged teens. We focus on spiritual reflection, community living, leadership development, and environmental stewardship. If selected, the applicant will be responsible for the direct supervision and safety of a tripping group of 7–14 people; teaching canoeing, backpacking and camping skills; leading devotional programs; and creating hands on activities for exploring the natural world.

Maturity and judgement as well as being a positive role model are important qualities for an Amnicon Staff member. We are therefore eager to select those individuals whose personal attributes and abilities indicate that they have the greatest potential for working successfully with youth.

Please give careful consideration to the questions listed below. Your assistance is greatly appreciated.


How long have you known this applicant?
What is the nature of your association?


Please indicate all qualities describing the applicant.

Assertive Dependable Empathic Self-starter
Cheerful Moody Follower High energy
Determined Creative Leader Easy going
Permissive Outgoing Listener Disciplined
Flexible Private Shy Approachable
Patient Serious Cooperative Respectful
Safety minded Team player Self confident



What do you see as the applicant's greatest strength and greatest weakness with regard to this staff position?




Describe how you see this person living out their faith?




Please make any other comments you feel are appropriate.
Especially consider safety, attention to detail and interaction with coworkers and campers.




Please select one corresponding rating for each of the attributes below.

motivation for youth work: Outstanding Excellent Good Fair Poor Don't know
genuineness & commitment: Outstanding Excellent Good Fair Poor Don't know
emotional stability: Outstanding Excellent Good Fair Poor Don't know
performance under pressure: Outstanding Excellent Good Fair Poor Don't know
empathy, tact: Outstanding Excellent Good Fair Poor Don't know
sensitivity to others: Outstanding Excellent Good Fair Poor Don't know
judgement & maturity in sensitive situations: Outstanding Excellent Good Fair Poor Don't know
creativity, skill in managing resources: Outstanding Excellent Good Fair Poor Don't know
reliability, promptness & conscientiousness: Outstanding Excellent Good Fair Poor Don't know
communication skills: Outstanding Excellent Good Fair Poor Don't know
articulate & clear: Outstanding Excellent Good Fair Poor Don't know
tenacity, perseverance & followthrough: Outstanding Excellent Good Fair Poor Don't know
physical health: Outstanding Excellent Good Fair Poor Don't know
stamina & endurance: Outstanding Excellent Good Fair Poor Don't know
ability to arouse enthusiasm: Outstanding Excellent Good Fair Poor Don't know
ability to accept criticism: Outstanding Excellent Good Fair Poor Don't know
initiative: Outstanding Excellent Good Fair Poor Don't know
personal integrity: Outstanding Excellent Good Fair Poor Don't know



Is there any reason, that you know of, that this person should not be working with children and/or high school age youth?

no yes (If yes, please explain in the space below):




Please indicate your overall evaluation of this applicant for an Amnicon staff position.

Outstanding Excellent Good Fair Poor


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