2025 Portsmouth, Petersburg, Norfolk, Surry 4-H Camp Counselor Reference

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Thank you for serving as a reference for a teenager who is applying for a teen counselor or CIT position for the 4-H camp this summer. At 4-H camp teen counselors will supervise small groups of campers aged 9-13 in lodges at night, classes, and with larger groups during the day. This is a big responsibility and it is important that we have amazing teens there to guide the 4-H youth. This form we will be confidential and seen only by the 4-H Extension Agents in Surry and Portsmouth/ Norfolk. The first part of the reference will ask a few questions. Parts 2-6 will ask you to rate qualities of the applicant on a scale of excellent, good, fair, and poor. If you have any questions please reach out at armartin@vt.edu

Reference Name *

Phone *

Address

Applicant's Name *

How long have you known the applicant? *

In what capacity have you known the applicant *

Can you tell us how they work as a member of a team? *

What strengths do you believe the applicant has for the role of teen counselor? *

Would you be willing to let the applicant work with children? *

Yes

Would you recommended the applicant to serve as a 4-H Camp Counselor in a supervisory capacity? *

Yes

Other comments or information you think we need to know *

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