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Personal Reference Form 2022 C.I.T.

The Franklin Township Recreation Department operates summer day camps for children entering grades 1-6. The camps are staffed by recreation professionals, teachers, college and high school students with strong backgrounds in working with children. In addition, limited CIT positions are available to youth entering grades 9 & 10. CITs are expected to assist camp counselors in providing activities and supervision to our participants.

Applications and letters of reference due no later than MAY 13, 2022 (NO EXCEPTIONS!)

References may not be submitted by a relative of the applicant.

Applicant Name

Reference's Relationship

How long and what capacity have you know the applicant?

Would this applicant be a positive, suitable role model for children 5 - 12 years old? Please explain

Please feel free to make any additional statements concerning the applicant’s interest or readiness to participate in the CIT program.

What observations have you made regarding the applicant’s leadership qualities?

Are there any problems or concerns that might interfere with the applicant’s ability to perform as a CIT?

Survey Matrix
	Unable to Judge	Very Good	Good	Average	Poor
Energy and Initiative	Energy and Initiative/Unable to Judge	Energy and Initiative/Very Good	Energy and Initiative/Good	Energy and Initiative/Average	Energy and Initiative/Poor
Creativity and Originality	Creativity and Originality/Unable to Judge	Creativity and Originality/Very Good	Creativity and Originality/Good	Creativity and Originality/Average	Creativity and Originality/Poor
Reliability	Reliability/Unable to Judge	Reliability/Very Good	Reliability/Good	Reliability/Average	Reliability/Poor
Patience	Patience/Unable to Judge	Patience/Very Good	Patience/Good	Patience/Average	Patience/Poor
Commitment to job or task	Commitment to job or task/Unable to Judge	Commitment to job or task/Very Good	Commitment to job or task/Good	Commitment to job or task/Average	Commitment to job or task/Poor
Flexibility-adapts to changing situations	Flexibility-adapts to changing situations/Unable to Judge	Flexibility-adapts to changing situations/Very Good	Flexibility-adapts to changing situations/Good	Flexibility-adapts to changing situations/Average	Flexibility-adapts to changing situations/Poor
Displays a positive attitude	Displays a positive attitude/Unable to Judge	Displays a positive attitude/Very Good	Displays a positive attitude/Good	Displays a positive attitude/Average	Displays a positive attitude/Poor
Ability to work with and relate to children	Ability to work with and relate to children/Unable to Judge	Ability to work with and relate to children/Very Good	Ability to work with and relate to children/Good	Ability to work with and relate to children/Average	Ability to work with and relate to children/Poor
Cooperative	Cooperative/Unable to Judge	Cooperative/Very Good	Cooperative/Good	Cooperative/Average	Cooperative/Poor

We greatly appreciate your time and effort. Selecting a positive role model for children is no easy task! Your assistance in our program will make a difficult selection process easier, enabling us to choose the best candidates. References received after the due date of 5/13/22 will not be considered. Thank you.

Due date for references is May 13, 2022 4PM

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