Camphill Association of North America
Reference Request
Camphill Communities in North America and worldwide offer service opportunities
for volunteers to live and work in intentional communities together with people with
developmental and other disabilitie s. The person named below has applied to serve
in a Camphill community, and has indicated that you would be able to evaluate
her/his suitability for this experience in a candid way.
Name of applicant
(first, last middle)
Having a successful Camphill volunteer experience largely depends upon an
appropriate match between the person, the expectations and the community.
Considerable value is placed on personal references during the application review
and selection process. We greatly appreciate your input. Please return your
reference electronically or place in a sealed envelope with your signature across the
seal and forward to the applicant.
This reference form is a confidential document and will not be viewed by the
applicant.
Name of referee
(first, last middle)
Relationship to client
Position / title
Organization (if
applicable)
Address
Phone (H)
(W)
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Knowledge of the applicant
How long have you known
the applicant
In what capacity have you
known the applicant?
Please describe th e
situation.
Work performance
Please comment, from what
you have observed, on such
qualities as the applicant’s
level of: dependability
• initiative
• ability to work with
minimal supervision
• work as a member
of a team.
Please comment from what
you have observed, how
competent do you view this
applicant, as demonstrated
by work in the community,
at school, on the job, or in
a position of responsibility?
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Relationships with other people
Camphill co -workers are
required to understand
other people’s viewpoints
and problems and to
communicate with people
from different backgrounds
and ability levels. Please
comment, from what you
have observed, on the
applicant’s relationships
with others.
Emotional maturity
Please comment, from what
you have observed, about
the applicant’s ability to
adapt and work under
difficult and changing
conditions.
Working with people in need of support and care
Please comment, from
what you have observed, of
the applicant’s ability to
work side b y side in a
respectful relationship of
mutual regard for people
with a learning disability,
physical disability, perhaps
with limited verbal
language, often in need of
personal physical care.
Additional comments and supporting information
Please feel free to add
here any additional
comments you think are
relevant.
This could be how you have
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observed the applicant’s
desire to serve others,
aspirations, maturity, work
ethic, special gifts,
flexibility and
dependability.
What advice/suggestions
would you want to offer to
offer us in working with
this applicant?
Overall recommendation
What is your overall
recommendation?
Please sign and date this
form here.
Thank you
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