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An applicant you know is under consideration to be a counselor at Camp Honey Creek for Girls.

Her duties will
require her to be in contact both with young girls from the age of six through seventeen and with adults of all
ages. In light of this information, an honest and thoughtful appraisal of her character and personality will be of
the greatest help to us and will be treated in the strictest confdence. Will you please give us your candid opinion
of the applicant? Applicant’s Name:
I.
Superior Good Average Poor NA
Physical health and stamina
Emotional stability
Promise and capacity for development of emotional stability
Humor and fexibility
Cooperative and alert attitude
Exhibits loyalty and integrity in all associations
Conservative good taste in dress and general behavior
Does applicant seem to you to display normal intelligence plus sound common sense? ___ Yes ___ No
Is applicant hyper-critical or hyper-sensitive? ___ Yes ___ No
Does applicant possess any physical, mental or emotional limitations which might seriously detract from
possible job performance? ___ Yes ___ No
II. In your opinion, is the applicant mature enough to:
Superior Good Average Poor NA
Be responsible for children in a camp setting?
Work with children with genuine patience, enthusiasm and skill?
Get along with co-workers under close living conditions?
Place needs of others and the group above own desires and needs?
Assume responsibility for carrying out delegated duties?
Discipline self in order to use her time to best advantage?
Accept on-going guidance and supervision?
Accept constructive criticism as well as praise?
Flexible enough to accept changing conditions and assignments?
Abide by camp policies?
Maintain energy and enthusiasm over an extended period?
Make responsible decisions in emergency situations?
III. Please check the statements which best describe this applicant:
___ almost always seems happy ___ talks to supervisor about problems in job
___ gets along well with all people ___ follows through on responsibilities
___ does not make a good frst impression, but ___ gets angry easily – loses temper
wears well ___ has self-confdence
___ accepts suggestions and corrections graciously ___ fnds change difcult
___ feels that supervisors are unduly critical ___ takes initiative
___ tends to be dictatorial ___ adaptable to situations
___ tolerant of other’s ideas and desires ___ self-centered
___ lacks self-confdence ___ discusses job problems with everyone
___ often moody and depressed ___ has a genuine interest in people
___ seems to enjoy dissention
CAMP HONEY CREEK
P.O. Box 140 Confdential Appraisal Form
Hunt, TX 78024
Ana Marcela Díaz Cerda

IV. Are you related to applicant in any way? ___ Yes ___ No If yes, how
V. How long have you known applicant?
Would you hire this applicant? ___ Yes ___ No
VI. Do you know of any religious, cultural or racial prejudice applicant might have that would limit the
applicant’s ability to work with all children and staf? ___ Yes ___ No
VII. Do you know of any personal habits, behavior or any other circumstances (i.e.: drugs, alcohol, etc.) which, in
your estimation, disqualifes applicant for the position of guiding and instructing young girls?
___ Yes ___ No If yes, please explain:

VIII. Would you be willing for your daughter to be associated with the applicant in a living and teaching
situation such as this? ___ Yes ___ No
IX. Do we need to check additionally on this applicant? ___ Yes ___ No
X. Do you know if applicant has ever been convicted of a felony or misdemeanor? ___ Yes ___ No
If yes, please explain:

PLEASE LIST ANY OTHER INFORMATION YOU FEEL WOULD IN ANY WAY BE HELPFUL IN GIVING US AN INSIGHT
INTO THIS APPLICANT’S CHARACTER, JOB PERFORMANCE, AND ABILITY TO BE A POSITIVE ROLE MODEL FOR OUR
YOUNG CAMPERS. THANK YOU.









Date _______________________________________ Name _______________________________________
Title _______________________________________
Phone Number _______________________________________
CAMP HONEY CREEK, BOX 140, HUNT, TX 78024
PHONE 830-238-4630 FAX 830-238-4136 E-MAIL chc@camphoneycreek.com
3 years and a half
I've known the applicant for more than 3 years. I can tell without mistake that she is a very
responsible girl and she's totally accurate for this opportunity. She's grown up in every sense
through the years, becoming a very self centered person and a very good example of what a young
succesful and happy woman should be.
In my personal opinion, I'm completely sure Ana will completely commited to this opportunity,
seizing every moment of it and giving the best of her in any kind of situation.
I would be pleased if my daughter had the opportunity to meet a girl like Ana, and I'd like her to be a
guide for my daughter if it was possible.
It's the kind of girl you imagine as a daughter and friend for life.
2/26/14 Ana Celeste Hernández Villegas
Career Counselor
0448712431566
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