This contact form is for anyone who has been listed as a reference for an individual who is applying for an internship at Fort Caswell. Caswell serves as a retreat and conference center for church groups, families, and non-profit organizations on a year-round basis.

    Thank you for taking the time to fill out this form.

    Person for whom you are filling out this reference form:

    What is your relationship to the applicant?

    In what capacity and how long have you known the applicant?

    What type of friends does he or she choose?

    To what extent is the applicant active in church or other religious activities to your knowledge?

    Does the applicant possess any special abilities?

    Does the applicant seem to have a genuine spiritual commitment?

    Keeping our camp setting described above in mind, please rate the applicant using the following scale of performance:

    5 = superior
    4 = above average
    3 = average
    2 = below average
    1 = poor
    0 = no observation

    Attitudes and Personal Qualities

    Sense of responsibility:

    Self Confidence:


    Receptiveness to suggestions or criticism:

    Emotional maturity and stability:

    Ability to get along with peers:

    Interest in welfare of others:

    Positive attitude toward supervision:

    Positive attitude toward opposite sex:


    Sees tasks through to completion:

    Cooperates in group assignments:


    Commits wholeheartedly to work:



    Able to work under stress:

    Leadership potential:

    Willing to go beyond expectations:

    Please feel free to include any additional specific recommendations pertaining to this applicant.

    Thank you for your time and effort in supplying this information which will assist us in selecting the best people to the positions for which they are best qualified. Please remember, this applicant will not be considered until your reference is submitted.

    Please check the appropriate statement:

    I certify that by submitting this reference form, all information given is true to the best of my knowledge.yesno

    Your name:


    Your email address:

    Please include your daytime phone number so that we may call you and verify this reference if necessary, please use the format (XXX) XXX-XXXX

    Please double-check that you have completely filled out the form and press submit to send in to us.