2018 Staff Reference
Cross Trails Ministry
Lutheran Camp Chrysalis • Ebert Ranch Camp • Off-Site Programs • Day Camp
391 Upper Turtle Creek Road Kerrville, Texas 78028
830.257.6340 Phone • 830.257.3060 Fax • www.crosstrails.org

Confidential Reference Form for Employment

The person named below is applying through Cross Trails Ministry for a Summer position at Lutheran Camp Chrysalis, Ebert Ranch Camp, Off-Site or Day Camp programs. Each of these camps offer Christian youth summer programs. We are looking for mature, responsible persons to work with both young people and adults. Our staff lives closely with others and must be willing to challenge themselves spiritually, physically, and emotionally.

Your name has been given as a reference for this applicant. We appreciate your time and consideration in completing this form. Our supervisory staff may make a follow-up phone call at a later time. All responses will be kept confidential.

Applicant Information
The applicant has authorized the request for information, and releases all parties from liability for any damage that may result from furnishing this information. The applicant understands that the information given will be kept confidential between Cross Trails Ministry and the Reference
First Name of Applicant *
Your answer
Last Name of Applicant *
Your answer
Email of Applicant
Your answer
Phone Number of Applicant
xxx-xxx-xxxx
Your answer
Reference Information
Reference First Name *
Your answer
Reference Last Name *
Your answer
Reference Title/Position *
Your answer
Phone Number of Reference *
xxx-xxx-xxxx
Your answer
Good Times to Call *
Your answer
Address of Reference *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
How well and in what capacity do you know the applicant? *
Your answer
Would you feel comfortable with the applicant caring for your child? *
Has the applicant, to your knowledge, used alcohol to excess or illegal drugs? *
If yes, please explain
Your answer
Are you aware of any inappropriate sexual contact or physical abuse between the applicant and any person with whom he or she has worked or volunteered? If yes, please explain. *
If yes, please explain
Your answer
Have you ever employed or are you currently the employer of the applicant? *
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