Cross Bar X Youth Ranch

Who is the person you are filling out this reference for?

First Name *

Last Name *

The person named above has applied to serve at Cross Bar X Youth Ranch (CBX), as one of our staff or as a staff member for the Colorado Outdoor Learning School (COLS), hosted at CBX. CBX is a Christian camp that provides summer camps for underprivileged youth from low-income families as well as outdoor education for public, private, and independent schools.

The staff that work on location at Cross Bar X Youth Ranch are one of our most vital assets and we are interested in learning about each applicant. Our staff positions require hard work and a willingness to serve. Please fill out the following questions as honestly as you are able. Please mark "N/A" for any questions you feel unqualified to answer.

This form should take you 20-45 minutes to fill out. It is recommended that you complete the form in one sitting. If you do leave this page or close your browser, this form will automatically save your progress in your browser. We recommend you refrain from clearing cache, history, or cookies until you successfully submit your application. Please direct any question to Jacob Posey jacob@crossbarx.org.

How long have you known the applicant? In what capacity? *

What was the nature of the work done by the applicant? *

Character Assessment

What was the applicant’s attitude toward his/her work? *

Did the applicant display a willingness to learn? *

For the next five questions, please select the phrase that best describes the applicant.

5. Does the applicant possess leadership ability? *

Describe the applicant’s ability to form, execute, and follow through on plans. *

Describe the applicant’s emotional temperament. *

Describe the applicant’s personality *

How well does the applicant work with associates and others for the good of the group? *

For the next series of questions, please assess the applicant's characteristics and traits.

1 = weak

5 = superior

Personal Appearance *

Tact *

Physical Condition *

Dependability *

Judgment *

Attitude towards authority *

Ability to work with others *

Ability to make friends *

Sense of humor *

Courtesy *

Honesty and personal integrity *

Initial impression *

Punctuality *

Willingness *

Attitude towards the opposite sex *

Attitude towards superiors *

Attitude towards hard work *

Initiative *

Ability to handle a physically and emotionally demanding schedule *

Additional comments on the graded characteristics above

In what ways does the applicant need to be nurtured and encouraged to grow? *

How does the applicant react in situations of stress? (i.e. maturity of judgement in making decisions) *

Is he/she dependable? Does this person weaken in absence of authority? *

Are there any tendencies of traits which you feel might reduce the effectiveness of the applicant in a camping program? If so, please explain: *

Are you recommending the applicant because of what he/she can contribute to our program? Or because of what we could do for him/her Or both? *

Would you want your own child or teenager placed under the direct charge and influence of this individual? Please explain: *

Please provide any additional comments you feel would help us in considering the Applicant. *

Your Contact Information

First Name *

Last Name *

Street Address *

Street Address Line 2

City *

State *

Zip / Postal *

Country *

Phone *

Date *