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REFERENCE FORM FOR JESSICA BUTLER

MJCCA SUMMER DAY CAMP REFERENCE FORM

This individual has applied for a job within our summer camp program, which
serves approximately 1800 children and teens annually.

Each MJCCA Summer Day Camp staff member interacts closely with our campers and
assumes a share of the responsibility and leadership required to make our
program a success.

Serving on the staff of an MJCCA Day Camp demands high standards of maturity,
competence, dedication and character. Your time in giving us a candid and
confidential evaluation of this applicants abilities, attitudes, maturity,
dedication and ethics is greatly appreciated, not only by us, but by the parents
who will entrust us with the care of their children this summer.

Thank you for your time and assistance.

Please briefly describe your relationship to this applicant:

For how long have you known this applicant?

Please classify your knowledge of this applicant as:
Professional Personal
Please indicate all qualites, which accurately describe this applicant:
AssertiveCheerfulCooperativeCreativeDependableDeterminedEmpatheticEnergeticFlexibleIndependentMotivatedOpen-MindedPatientPersuasivePolitePrecausionsRespectfulSerious
Which of the aforementioned qualites do you find most prevalent in this
applicant? Why?

Please describe this applicants greatest strengths:

Please describe this applicants greatest weaknesses:

Do you believe this applicant to be an effective leader? Why

Do you believe this applicant can be a postive role model for children and/or
peers? Why?


Please rate this applicant to the best of your knowledge in the following
categories:

Commitment
Superior Above AverageAverageBelow AveragePoor
Tenacity and Perseverance
Superior Above AverageAverageBelow AveragePoor
Reliability and Promptness
Superior Above AverageAverageBelow AveragePoor
Communication Skills
Superior Above AverageAverageBelow AveragePoor
Performance under Pressure
Superior Above AverageAverageBelow AveragePoor
Ability to Accept Criticism
Superior Above AverageAverageBelow AveragePoor
Personal Integrity
Superior Above AverageAverageBelow AveragePoor
Knowledge of Judaism
Superior Above AverageAverageBelow AveragePoor
Judgment and Maturity
Superior Above AverageAverageBelow AveragePoor
Self-control and Poise
Superior Above AverageAverageBelow AveragePoor
Adaptability
Superior Above AverageAverageBelow AveragePoor
Use of Appropriate Language
Superior Above AverageAverageBelow AveragePoor
Ability to Work With Peers
Superior Above AverageAverageBelow AveragePoor
Ability to Relate to Children
Superior Above AverageAverageBelow AveragePoor
Is there anything further you feel we should know when considering this
applicant?


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MJCCA
5342 Tilly Mill Road
Dunwoody, GA 30338
678.812.4000

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