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[COUNSELOR] has given your name as a reference in applying for a summer counseling position at Loucon Training & Retreat Center, a Christian camp for children and youth operated by the Kentucky Conference of the United Methodist Church. Your critical and confidential evaluation will be of great help to us in selecting the best possible counselors. We are looking for people who are mature, loving, enthusiastic, responsible, and who are of good Christian character. They should possess the ability to get along with children, youth, and adults. It is important that each counselor work well with people and have the physical stamina for outdoor living. They will be role models and caretakers for the children and/or youth whom are placed under their responsibility.

Please thoroughly answer the following questions and then mail this reference form to the address listed at the end of this form.

Would you allow the applicant to be responsible for your children in a camping situation?
Have you been witness to the applicant interacting with children and/or youth?
Do you believe this applicant is spiritually mature enough to share his/her faith with the youth and children at Loucon?
If the applicant has worked for you, would you be willing to rehire them?
In your opinion is the applicant physically able to enjoy a summer in the outdoors in the Kentucky climate?
Do you know of any characteristics that would negatively affect the applicant's ability to work with children and/or youth?
Do you have any knowledge that the applicant has ever been convicted of a crime?

Please rate the applicant in the following areas to the best of your knowledge. Check the box that best describes the applicant.

Please rate the applicant as a potential counselor:

Thanks for submitting!

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