YMCA Blue Ridge Assembly: Reference Inquiry

Reference Inquiry

YMCA Blue Ridge Assembly
84 Blue Ridge Circle
Black Mountain, NC 28711
(828) 669-8422 • FAX (828) 669-8497
Owned by the YMCAs of the South

Please complete and return to Staff Development Director at the above address. Blue Ridge Assembly conducts a collegiate work-study program. It involves working in customer service departments, living in Assembly dormitories and participating in staff recreation, spiritual and educational programs.

Name of Applicant	___________________________	Date	___________________________
Your Name	___________________________	Address	___________________________
Telephone	___________________________		___________________________

This person is being considered for employment by our organization and has granted permission for information concerning his/her character to be secured. Your confidential answers to the following questions will help us better evaluate the applicant. Thank you for your assistance.

Qualities	Superior	Very Good	Good	Fair	Poor	Not Known
Character
General Attitude
Ability to Get along with Others
Communication with Others
Trustworthiness / Dependability
Honesty
Independent Initiative
Observance of Rules and Regulations
Acceptance of Supervision
Behavior/ Emotional Stability
Personal Habits
Safety Habits
judgment
Leadership

How many years have you known this person? ______________

What is your relationship to this person? ___________________________

What do you feel are this person’s major strengths and weaknesses? Please be specific. Use reverse side for any additional comments.

Do you recommend the acceptance of the applicant as an employee of YMCA Blue Ridge Assembly?

Signature ______________________________________________________

Date _____________